In-hospital treated pediatric injuries are increasing in Finland--a population based study between 1997 and 2006
J S Suominen1, M P Pakarinen, S Kääriäinen
1Section of Paediatric Surgery, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland. janne.suominen@hus.fi
Insights
Pediatric trauma incidence is rising, particularly fractures and abdominal injuries, despite decreasing head trauma and mortality rates. Unnecessary spleen surgeries remain a concern in Finland.
Area of Science:
- Public Health
- Pediatric Traumatology
- Injury Epidemiology
Background:
- Injuries represent a significant public health issue and a leading cause of death and disability in children.
- Understanding pediatric trauma trends is crucial for effective public health interventions.
Purpose of the Study:
- To longitudinally analyze the incidence, operative treatment, and mortality of in-hospital treated traumas in pediatric patients in Finland.
- To identify trends in specific injury types and their impact on overall pediatric trauma outcomes.
Main Methods:
- Utilized data from the National Hospital Discharge Register and Official Cause-of-Death Statistics in Finland.
- Analyzed hospitalizations, treatment modalities, and mortality for pediatric trauma patients from 1997 to 2006.
Main Results:
- Fractures (69%) and head injuries (28%) were the most common traumas. Head trauma incidence decreased by 13.6%, contributing to a 30% drop in injury-related mortality.
- Overall trauma incidence, fractures, and abdominal injuries significantly increased (5.0%, 13.5%, and 37%, respectively).
- Head traumas accounted for 67% of injury-related deaths, and up to 15% of spleen injuries resulted in splenectomy.
Conclusions:
- Despite declining head trauma and overall mortality, rising rates of fractures and abdominal injuries increase severe injury incidence in Finnish children.
- A notable percentage of splenectomies for spleen injuries in children appear to be unnecessary, indicating a need for revised treatment protocols.
Background And Aims:
Injuries are an important public health problem as well as the leading cause of death and disability among children. Our aim was to longitudinally explore the incidence of in-hospital treated traumas, their operative treatment and related mortality among pediatric patients in Finland.
Methods:
The National Hospital Discharge Register and the Official Cause-of-Death Statistics data of in-hospital treated pediatric trauma patients between 1997 and 2006 in Finland were evaluated for hospitalizations, treatment modality and mortality.
Results:
Fractures (69%) and head injuries (28%) were the most common in-hospital treated traumas (477/100,000 persons/year). These were followed by injuries of intra-abdominal (1.4%), thoracic (1.2%) and urological organs (0.6%). Head traumas constituted 67% of injury-related deaths. During the ten-year follow-up period, the annual incidence (per 100,000 persons) of head injuries decreased by 13.6% (152 in 1997 vs. 131 in 2006, p < 0.0001) mainly contributing to a 30% decrease in overall injury-related mortality incidence (from 5.7 in 1997 to 4.0 in 2006, p = 0.0519). The overall trauma incidence, and incidence of fractures and abdominal injuries significantly increased by 5.0% (p < 0.0001), 13.5% (p < 0.0001) and 37% (p < 0.05), respectively, while the incidence of thoracic and urological injuries remained unchanged. Up to 15% of spleen injuries lead to splenectomy.
Conclusions:
Although overall and head trauma-related mortality is decreasing, the increasing incidence of fractures and abdominal injuries has amplified the overall incidence of severe injuries among children in Finland. A significant number of unnecessary splenectomies are still performed among children.
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