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Causes and Characteristics of Children Unintentional Injuries in Emergency Department and Its Implications for
Hairong Gong1, Guoping Lu1, Jian Ma1
1Emergency Department, Children's Hospital of Fudan University, Shanghai, China.
Insights
Child unintentional injuries are common, with preschool boys most affected. Transport and high fall injuries pose the greatest risk for hospital admission, necessitating targeted prevention strategies.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Child unintentional injuries are a global concern with significant regional variations.
- Limited data exist on the causes and characteristics of pediatric unintentional injuries in China.
- This study addresses the data gap by analyzing injury patterns in Shanghai.
Purpose of the Study:
- To investigate the causes, characteristics, and risk factors of unintentional injuries in children presenting to a Shanghai hospital.
- To identify specific injury mechanisms and demographic factors associated with hospital admission.
- To inform targeted injury prevention strategies in the Chinese context.
Main Methods:
- Cross-sectional study of 29,597 children (<18 years) with unintentional injuries from January 2017 to December 2018.
- Data extracted from electronic health records, including demographics and injury details.
- Statistical analyses included chi-square tests, t-tests, and logistic regression to identify risk factors for admission.
Main Results:
- Preschool-aged children constituted approximately two-thirds of all unintentional injuries.
- Boys experienced a higher incidence of unintentional injuries than girls (1.75:1 ratio).
- Transport injuries and high falls significantly increased the risk of hospital admission (ORs 1.31 and 2.58, respectively).
Conclusions:
- Age and gender significantly influence unintentional injury patterns in children.
- Transport and high fall injuries require focused preventive interventions due to their high admission risk.
- Understanding injury epidemiology is crucial for developing effective public health strategies for child safety.
Abstract:
Background: Child unintentional injuries have become a hot topic worldwide, and substantial regional disparities existed in causes and characteristics. To date, limited data are available to investigate the causes and characteristics of child unintentional injuries from hospitals for children in China. Methods: A cross-sectional study was conducted between January 2017 and December 2018 in Shanghai, China. Patients aged <18 years with an unintentional injury presented to the emergency department were enrolled. Demographic information, Pediatric Risk for Mortality III score, and outcome variables were retrieved from electronic health records (EHRs). Frequencies and proportions of categorical variables and means and SDs of continuous variables are presented. Chi-square test and Student's t-test were used for the comparison between groups, as appropriate. Logistic regression analysis was used to estimate potential risk factors for admission to the hospital. Results: A total of 29,597 cases with unintentional injuries were identified between January 2017 and December 2018, with boys vs. girls ratio of 1.75. Preschool children account for approximately two-thirds of unintentional injuries in the emergency department. A distinctive pattern of mechanisms of unintentional injuries between gender was documented, and sports injury was significantly higher in boys than in girls (10.2 vs. 7.8%). Compared with Canadian Emergency Department Triage and Acuity Scale (CTAS) Grade 3 patients, Grade 2 [odds ratio (OR) = 2.99, 95% CI = 1.93-4.63, P < 0.001] and Grade 1 (OR = 74.85, 95% CI = 12.93-433.14, P < 0.001) patients had higher risk of inhospital admission. For causes of injuries, compared with falling, foreign body and poison had a lower risk of inhospital admission, while transport injury (OR = 1.31, 95% CI = 1.07-1.59, P = 0.008) and high fall injury (OR = 2.58. 95% CI =1.48-4.49, P < 0.001) had a significantly higher risk of admission. Conclusions: There was a significant relationship between age-groups and unintentional injuries between gender, with decreased injuries among girls growing up older. Preventive measures should be taken to reduce transport injury and high fall injury, which had a significantly higher risk of admission.
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