A National Trauma Data Bank Analysis of Shark-Related Injuries on a Pediatric Scope

Background Shark-related injuries (SRIs) in children are rare events but can result in significant morbidity due to the force and mechanism of shark bites. As coastal water use increases globally, shark-human interactions are becoming more common, creating new challenges for trauma systems and clinical management. Methods This retrospective observational study used the National Trauma Data Bank (NTDB) to characterize the frequency, injury patterns, severity, and clinical outcomes of pediatric SRIs in patients aged zero to 16 years from 2017 to 2021. Demographics, injury location, injury severity, hospital course, and operative interventions were analyzed. Results Among 520,795 pediatric trauma records, 26 cases (0.005%) were SRIs with a median age of 12 years and predominantly males (73.1%). Injuries most commonly affected the lower extremities (65.4%), followed by upper extremities (26.9%) and combined extremity injuries (7.7%). Surgical intervention was required in 25 of 26 patients, totaling 120 procedures, most commonly soft tissue operations (65.8%), followed by orthopedic (30%) and neurovascular (4.1%) procedures. The median Injury Severity Score was 5, and the median hospital length of stay was three days. Seven patients (28%) required ICU care. No in-hospital mortality occurred.  Conclusion SRIs in children remain rare. Despite generally low injury severity with short ICU and hospital stay, nearly all cases required surgical intervention primarily for soft tissue-related intervention, followed by orthopedic procedures. These findings highlight important considerations for trauma care in pediatric SRIs.