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Trends in moderate to severe paediatric trauma in Central Netherlands
Loes Janssens1, Herman R Holtslag2, Luke P H Leenen1
1Department of Surgery, University Medical Center Utrecht, The Netherlands.
Insights
The incidence of moderate to severe pediatric trauma in the Netherlands increased annually since 2001, driven by falls, sports, and bicycle injuries. This trend highlights specific groups for targeted injury prevention strategies.
Area of Science:
- Pediatric Trauma Research
- Injury Epidemiology
- Public Health Policy
Background:
- Hospital discharge data trend analyses can inform prevention policies but are susceptible to healthcare consumption changes.
- International criteria were employed to mitigate bias in analyzing clinical incidence of pediatric trauma.
- Identifying trends in pediatric trauma is crucial for developing effective prevention activities.
Purpose of the Study:
- To analyze trends in the clinical incidence of moderate to severe pediatric trauma.
- To identify specific demographic or activity-based groups at higher risk for targeted prevention efforts.
Main Methods:
- A retrospective analysis of pediatric trauma patients (0-18 years) discharged from hospitals in Central Netherlands (1996-2009).
- Inclusion criteria included Injury Severity Score (ISS) ≥ 4 and relevant ICD diagnostic codes and external cause codes.
- Poisson loglinear regression, adjusted for age and gender, was used for trend analysis.
Main Results:
- The study included 23,682 pediatric trauma patients, with a mean incidence of 477 per 100,000 person-years.
- Since 2001, moderate to severe pediatric trauma incidence rose by 1.1% annually, primarily due to increased falls (3.9%), sports injuries (5.4%), and bicycle injuries (3.8%).
- Falls and sports injuries were most prevalent in younger children (0-9) and older boys (10-18), respectively, while bicycle injuries affected children aged 5-18.
Conclusions:
- The incidence of pediatric trauma in the studied region of the Netherlands has shown an upward trend since 2001.
- Trend analysis of moderate and severe pediatric injuries can effectively pinpoint target populations for regional trauma prevention initiatives.
Introduction:
Trend analyses of hospital discharge data can raise signals for prevention policies, but are often flawed by changes in health care consumption. This is a trend analysis of the clinical incidence of paediatric trauma that used international criteria to overcome this bias. The objective is to describe trends in clinical incidence of moderate to severe paediatric trauma, and to identify target groups for prevention activities.
Patients And Methods:
Included were all paediatric trauma patients (0-18 years) that were discharged from the hospitals of trauma care region Central Netherlands from 1996 to 2009. Selection was made on ISS ≥ 4, and on trauma related International Classification of Diseases diagnostic codes, and trauma related external causes of injury and poisoning codes. Trend analyses were performed using Poisson loglinear regression with correction for age and gender.
Results:
23,682 Patients were included, the mean incidence rate was 477/100,000 person-years. Since 2001 the incidence rate of moderate to severe trauma increased with 1.1% annually (95% confidence interval (CI) 0.7-1.5), caused by an increase of falls (3.9%, 95% CI 3.3-4.5), sport injuries (5.4%, 95% CI 4.3-6.5), and bicycle injuries (3.8%, 95% CI 2.8-4.8). The incidence of falls and sport injuries peaked in young children (0-9) and older boys (10-18) respectively. Bicycle injuries affected all children between 5 and 18.
Conclusions:
The incidence of paediatric trauma in the centre of the Netherlands increased since 2001. Trend analyses on moderate and severe injuries may identify target groups for prevention in a trauma region.
