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Pediatric injury patterns by year of age
Elisabeth T Tracy1, Brian R Englum, Andrew S Barbas
1Department of General Surgery, Children's Hospital Boston, Boston, MA, USA.
Insights
Understanding pediatric trauma patterns is key to reducing child injuries. Motor-vehicle collisions and falls are leading causes, with specific trends in penetrating trauma needing attention for targeted prevention.
Area of Science:
- Pediatric Trauma Research
- Injury Epidemiology
- Public Health
Background:
- Trauma is a leading cause of death and disability in children.
- Understanding age-specific injury patterns can inform targeted prevention strategies.
- National databases offer valuable insights into pediatric injury trends.
Purpose of the Study:
- To identify pediatric injury patterns by year of age.
- To analyze leading mechanisms of injury (MOI) across different pediatric age groups.
- To inform targeted injury prevention efforts through data-driven insights.
Main Methods:
- Utilized the National Trauma Database (NTDB) Research Data Set 7.0 for patients aged 0-18 years.
- Included relevant ICD-9 external-cause-of-injury codes (e-codes).
- Analyzed data using χ(2) analysis and ANOVA, with significance defined as p<0.05.
Main Results:
- Identified 354,196 pediatric trauma patients.
- Leading MOI: motor-vehicle collisions (MVC) for ages 10-18, falls for ages 0-9.
- Higher rates of penetrating trauma observed in adolescents with public/no insurance; highest injury severity in infants and older adolescents.
Conclusions:
- Motor-vehicle collisions and falls remain primary pediatric injury mechanisms.
- Year-of-age analysis revealed significant trends, including unexpected rates of penetrating trauma.
- Findings support the development of targeted injury prevention strategies for pediatric populations.
Purpose:
Since trauma is the leading cause of death and disability among children, understanding injury patterns may reduce morbidity and mortality through targeted prevention efforts. The purpose of this study was to identify pediatric injury patterns by year of age using a large national database.
Methods:
We searched the National Trauma Database (NTDB) Research Data Set 7.0 for patients aged 0-18 years with the following relevant ICD-9 external-cause-of-injury codes (e-codes). We also reviewed our institutional trauma registry data (1999-2009). Data were analyzed using χ(2) analysis and ANOVA with significance defined as p<0.05.
Results:
We identified 354,196 pediatric trauma patients. The leading MOI were motor-vehicle collisions (MVC) for ages 10-18 years and falls for ages 0-9 years. Fire was the second leading MOI among 1-year-olds, but not a major MOI in other age groups. Penetrating trauma was the MOI for 21% of injuries among adolescents with public or no insurance (versus 7.5% adolescents with private insurance). Injury severity scores were highest for children <1 year old and children 14-18 years old. Our review of 1209 patients from our institution yielded additional detail.
Conclusion:
MVC and falls remain leading pediatric MOI. In our year-of-age analysis, we found several interesting trends, including a higher-than-expected rate of penetrating trauma. Our findings may support targeted injury prevention efforts.
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