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Accidental injury attendances as predictors of future admission
1Department of Public Health Medicine and Epidemiology, University of Nottingham Medical School, Queen's Medical Centre.
Insights
Children admitted for accidental injuries were twice as likely to have previously visited an accident and emergency (A & E) department. Previous A & E visits predict future injuries requiring hospital admission.
Area of Science:
- Pediatric emergency medicine
- Injury prevention research
- Public health epidemiology
Background:
- Accidental injuries are a significant cause of hospital admissions in young children.
- Understanding pre-hospital care patterns may inform injury prevention strategies.
Purpose of the Study:
- To investigate the association between prior accident and emergency (A & E) department attendance and subsequent hospital admission for accidental injury in children under five.
- To identify risk factors for severe accidental injuries in pre-school children.
Main Methods:
- A case-control study involving 342 matched pairs of children under five years old.
- Matched on sex and date of birth, comparing children admitted for accidental injury (cases) with community controls.
- Exposure measures included prior A & E attendance, injury type, and number of earlier attendances, adjusted for social deprivation and proximity to hospital.
Main Results:
- Children admitted for accidental injury were twice as likely to have previously attended an A & E department compared to controls.
- A higher number of previous A & E attendances was associated with increased risk of admission.
- Significantly elevated odds ratios were observed for soft-tissue injuries and lacerations.
Conclusions:
- Prior attendance at an A & E department is a predictor of accidental injuries requiring hospital admission in pre-school children.
- Notifying health visitors of A & E attendances could enhance accident prevention efforts.
- Early intervention following initial A & E visits may reduce subsequent severe injuries.
Abstract:
A case-control study was carried out in Nottingham Health District, to establish whether children under five years of age admitted to hospital after a accidental injury were more likely to have previously attended the accident and emergency (A & E) department than community controls. The subjects were 342 case-control pairs matched on sex and date of birth, consisting of children under five years resident in the Health District, and the main exposure measures were attendance at the A & E department before the case's first admission, type of injury and number of earlier attendances. It was found that, after adjusting for social deprivation score and proximity to hospital, children who had been admitted after an accidental injury were twice as likely to have attended the A & E department than community controls, and were more likely to have had more than one earlier attendance. Odds ratios were significantly raised for soft-tissue injuries and lacerations. It is concluded that accidental injuries in pre-school children that require attendance at the A & E department predict accidental injuries requiring admission. Making attendances at A & E departments notifiable to health visitors would facilitate the undertaking of accident prevention work.