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Traumatic Pediatric Fatalities: Are They Preventable?
Samara L Lewis1, Heather Liebe2, Christopher Jeffery1
1The University of Oklahoma Health Sciences Center, Department of Surgery, Oklahoma City, Oklahoma.
Insights
Many pediatric trauma fatalities are preventable, with injury mechanisms varying by age. Understanding these patterns is crucial for developing targeted injury prevention strategies in children.
Area of Science:
- Pediatric Trauma Research
- Injury Prevention Science
- Public Health
Background:
- Traumatic injuries are a leading cause of mortality in pediatric patients.
- A significant proportion of these injuries are preventable.
- Effective injury prevention requires understanding specific mechanisms of injury (MOI).
Purpose of the Study:
- To identify the MOI in pediatric trauma fatalities.
- To determine the preventability of these injuries.
- To inform future injury prevention efforts in trauma programs.
Main Methods:
- Retrospective review of pediatric trauma fatalities (age ≤18) from 2010-2019.
- Data collection included MOI, protective device use, demographics, and injury preventability.
- Statistical analysis involved age cohort stratification and bivariate testing.
Main Results:
- MOI varied significantly by age group.
- Non-accidental trauma was the leading cause of death in children under 5.
- Motor vehicle collisions (MVC) were most common in older children; gunshot wounds (GSW) in adolescents.
- A majority of fatalities, particularly in younger children, resulted from preventable injuries.
Conclusions:
- Many pediatric trauma fatalities are preventable.
- Injury prevention strategies should be tailored based on age-specific MOI.
- This data can guide focused interventions to reduce pediatric trauma mortality.
Introduction:
Trauma related injury remains the leading cause of mortality in pediatric patients, many of which are preventable. The goal of our study was to identify the mechanism of injury (MOI) in pediatric trauma-related fatalities and determine if these injuries were preventable to direct future injury prevention efforts within trauma programs.
Methods:
After IRB approval, a retrospective, single-institution review of pediatric (age ≤18) trauma fatalities from 2010 to 2019 was performed. MOI, use of protective devices, demographics, and whether the injury was preventable were collected. Patients were divided into five age cohorts, and frequencies and proportions were used to summarize data. Bivariate testing was done using Fisher's exact and Monte Carlo estimates for the exact test.
Results:
MOI was found to vary by age with non-accidental trauma found to be the most common cause of trauma related deaths in children <1 (88.5%) and 1-4 (33.3%). MVC was the most common MOI in children >5 y, with 68.4% in the 5-9, 34.4% in the 10-14, and 45.8% in the 15-18 age group. The majority of fatalities resulted from a preventable injury (P < 0.0001) in the younger children with a negative association as age increased: 92.3% <1, 53.3% in 1-4, 36.8% in 5-9, 46.9% in 10-14 and 48.6% in 15-18. Of the preventable injuries, non-accidental trauma was the most common MOI in children <5, while GSW was the most common MOI in children >10.
Conclusions:
This study demonstrates many pediatric fatalities are the result of a preventable traumatic injury. This data can guide focused traumatic injury prevention efforts.
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