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Where to start? Injury prevention priority scores in Canadian children
Samuel Jessula1, Mark Asbridge2, Rodrigo Romao3
1Division of General Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada.
Insights
Falls are the leading cause of injury in Canadian children, impacting mortality, severity, and healthcare costs. Prioritizing fall prevention offers the greatest public health benefit for pediatric injury reduction.
Area of Science:
- Pediatric injury prevention research
- Public health policy
- Epidemiology of childhood injuries
Background:
- Limited resources necessitate prioritizing injury prevention strategies.
- Objective measures are needed to rank Mechanisms of Injury (MOIs).
- Canadian children face significant injury burdens.
Purpose of the Study:
- Develop objective, evidence-based Injury Prevention Priority Scores (IPPSs) for Canadian children.
- Prioritize MOIs based on mortality, injury severity, and resource utilization.
- Inform injury prevention policy and research investments.
Main Methods:
- Retrospective cohort study of Canadian pediatric injuries (0-19 years) from 2009-2014.
- Calculated IPPSs balancing MOI frequency with mortality rate, Injury Severity Score (ICISS), or hospitalization cost.
- Utilized ICD-10 codes for injury severity assessment.
Main Results:
- Falls, intentional self-harm, and drowning were top MOIs for mortality.
- Falls, drowning, and suffocation ranked highest for injury severity.
- Falls, fires, and intentional self-harm were leading causes of resource utilization.
Conclusions:
- Falls represent the most significant preventable injury mechanism for Canadian children.
- Targeting fall prevention yields the greatest potential benefit for the pediatric population.
- IPPSs provide a framework for evidence-based injury prevention prioritization.
Purpose:
Given limited resources, it is essential to determine which Mechanisms of Injury (MOIs) to prioritize for injury prevention policy and research. We developed objective, evidence-based Injury Prevention Priority Scores (IPPSs) for Canadian children across three prevention perspectives: mortality, injury severity, and resource utilization.
Methods:
We performed a retrospective cohort study of all injuries in Canada in individuals aged 0 to 19 years old from 2009 to 2014. For each MOI, an IPPS was calculated as a balanced measure of frequency and either mortality rate, median ICD-10 derived Injury Severity Score (ICISS), or median cost per hospitalization.
Results:
Of 87,017 injuries, 83,112 were nonfatal hospitalizations, and 3905 were deaths. Overall mortality rate was 0.04 deaths/injury, median ICISS was 0.994 (IQR 0.75-0.996), and median cost per hospitalization was CAD$3262 (IQR $2118-$5001). The top three mechanisms were falls (IPPS 72), intentional self-harm (IPPS 68), and drowning (IPPS 65) for mortality, falls (IPPS73), drowning (IPPS 61), and suffocation (IPPS 61) for injury severity and falls (IPPS 70), fires (IPPS 65), and intentional self-harm (IPPS 60) for resource utilization.
Conclusion:
Falls, if prevented, would provide the most benefit to the largest proportion of the Canadian pediatric population and should be targeted for injury prevention.
Level Of Evidence:
Level III.
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