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Pediatric Train Injuries: A 10-Year Review From the Pennsylvania Trauma Outcomes Study Database
Christopher Pennell1, Erika Lindholm1, Jacob Latreille2
1From the Department of Pediatric General, Thoracic, and Minimally Invasive Surgery, St Christopher's Hospital for Children.
Insights
Train-related injuries in children are severe, often involving orthopedic trauma or traumatic brain injuries. Geographic clustering suggests targeted safety interventions could reduce pediatric train accidents.
Area of Science:
- Pediatric Trauma
- Injury Epidemiology
- Public Health
Background:
- Train-related injuries in children result in significant morbidity and healthcare resource utilization.
- Understanding the epidemiology of these injuries is crucial for developing targeted prevention strategies.
Purpose of the Study:
- To review the burden of train injuries on the pediatric trauma system in Pennsylvania.
- To identify demographic, clinical, and outcome characteristics of pediatric train injury patients.
Main Methods:
- Retrospective review of the Pennsylvania Trauma Outcomes Study Database.
- Inclusion of patients younger than 18 years injured by trains between 2007 and 2016.
- Analysis of demographics, hospital course, outcomes, and resource utilization.
Main Results:
- Thirty-five pediatric patients were identified, with a median age of 15 years.
- Most common injuries included orthopedic trauma (57.1%) and traumatic brain injury (45.7%).
- High rates of intensive care unit admission (65.7%) and operative management (65.7%) were observed, with an 8.6% mortality rate.
Conclusions:
- Pediatric train injuries are severe, predominantly orthopedic or traumatic brain injuries.
- Geographic clustering and common injury mechanisms suggest potential for targeted safety interventions.
- Further research into specific prevention strategies is warranted.
Objectives:
Trains can cause severe injuries in pediatric patients requiring significant resource utilization. We sought to review train injuries in Pennsylvania to determine the burden of these injuries on the pediatric trauma system.
Methods:
We queried the Pennsylvania Trauma Outcomes Study Database to identify patients younger than 18 years injured by trains between 2007 and 2016. Demographics, hospital course, outcomes, and resource utilization were reviewed.
Results:
Thirty-five children from 17 Pennsylvania counties were included. Three counties accounted for 48.6% of injured children. The median age was 15.0 years, and most patients were White (60.0%) and male (77.1%). The median length of stay was 8.0 days and overall mortality 8.6%. Intensive care unit admission was required for 65.7%. The median Injury Severity and Functional Status at Discharge scores were 14.0 and 18.0, respectively. Major orthopedic injuries (fracture or amputation) were the most common (57.1%) followed by traumatic brain injury (45.7%), pneumothorax (14.3%), and solid organ injury (14.3%). Operative management was common with 65.7% undergoing surgery.
Conclusions:
Injuries caused by trains can be severe and are most commonly orthopedic or traumatic brain injuries. Targeted safety interventions may be possible given the common mechanisms and geographic clustering of these injuries.
