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Increased morbidity associated with weekend paediatric road traffic injuries: 10-year analysis of trauma registry
Brett Burstein1, Emmanuelle Fauteux-Lamarre1, Arjan Bastiaan van As2
1Division of Pediatric Emergency Medicine, Department of Pediatrics, The Montreal Children's Hospital of the McGill University Health Center, Montreal, Quebec, Canada.
Insights
Children are at higher risk for severe road traffic injuries (RTIs) on weekends in low- and middle-income countries. This highlights the need for targeted prevention strategies to improve child road safety.
Area of Science:
- Public Health
- Pediatric Trauma
- Injury Prevention
Background:
- Road traffic injuries (RTIs) are a major cause of child death and disability globally, especially in low- and middle-income countries (LMICs).
- While adult data suggest higher RTI risk on weekends in LMICs, this has not been studied in children.
- This study investigated pediatric RTI patterns in Cape Town, South Africa.
Purpose of the Study:
- To assess if children are at increased risk of road traffic injuries on weekends compared to weekdays.
- To analyze the severity of injuries and healthcare utilization for pediatric RTIs on weekends versus weekdays.
- To identify specific periods of heightened risk for pediatric RTIs.
Main Methods:
- Analysis of prospectively collected trauma registry data from Childsafe South Africa.
- Inclusion of injured children under 13 years old presenting to a tertiary pediatric trauma department (2004-2013).
- Comparison of RTI incidence, injury severity, and hospital admission rates between weekends and weekdays.
Main Results:
- RTIs accounted for 12.4% of 71,180 traumatic injuries in children, with higher daily incidence on weekends (2.98 vs. 2.19 patients/day).
- Weekend RTI patients experienced more severe injuries and had higher rates of admission to trauma wards and PICUs compared to weekdays.
- The last annual quarter's weekends showed the highest frequency of trauma ward and PICU admissions for pediatric RTIs.
Conclusions:
- Paediatric road traffic injury patients in LMICs are more likely to seek medical attention, sustain severe injuries, and require hospitalization during weekends.
- Weekends in the final quarter of the year represent a particularly high-risk period for pediatric RTIs.
- Findings underscore the value of trauma surveillance data for developing targeted community interventions to enhance child road safety.
Background:
Road traffic injuries (RTIs) are a significant cause of paediatric morbidity and mortality worldwide, with a disproportionate number of these injuries occurring in low- and middle-income countries (LMICs). Adult data from LMICs suggest that weekends are particularly high-risk for RTIs, but whether children are at increased risk of RTI on weekends has not previously been investigated in any setting. This study sought to assess patterns in paediatric RTI presentations using hospital-based trauma surveillance data in Cape Town, South Africa.
Methods:
Data was analysed from Childsafe South Africa's prospectively collected trauma registry for injured children below 13 years of age presenting to a tertiary paediatric referral Trauma Department between 2004 and 2013.
Results:
During the 10-year study period, a total of 71,180 patients presented with traumatic injuries, of which 8,815 (12.4%) resulted from RTIs. RTI patients had a mean age of 5.2±3.6 years, and were predominantly males and pedestrians. RTIs were more common on weekends than weekdays (2.98 vs. 2.19 patients/day, p<0.001), representing a greater proportion of daily all-cause trauma (15.5% vs. 11.2%, p<0.001). Moreover, weekend RTI patients sustained more severe injuries than on weekdays, and compared to weekend all-cause trauma patients (injury score 1.66 vs. 1.46 and 1.43, both p<0.001). RTI patients were more likely to require admission to both the trauma ward (1.14 vs. 0.79 patients/day, p<0.001) and the PICU (0.10 vs. 0.07 patients/day, p<0.05) on weekends than on weekdays. Weekend RTI patients most frequently required admission to the trauma ward (p<0.001) and the PICU (p<0.05) during the last annual quarter.
Conclusions:
In a LMIC-setting, paediatric RTI patients are more frequently brought to medical attention, sustain more severe injuries and more frequently require hospital admission during the weekend. Weekends during the last annual quarter were particularly high-risk for paediatric RTIs. These findings highlight the importance of trauma surveillance data to inform targeted community prevention strategies for improving child road safety.
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