Causes and characteristics of injury in paediatric major trauma and trends over time

Beck, Ben; Teague, Warwick J.; Cameron, Peter; Gabbe, Belinda

doi:10.1136/archdischild-2018-315565

Cited by 32 publications

(49 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the United States, where trauma reporting processes have been more stable, an 8.3% reduction in injury-related presentations was noted between 2006 and 2012 14. Similarly, there has been no increase in reported paediatric major trauma in recently reported data from Australia 15…”

Section: Discussionmentioning

confidence: 98%

Epidemiology of adolescent trauma in England: a review of TARN data 2008–2017

et al. 2019

View full text Add to dashboard Cite

ObjectivesTrauma contributes significantly to adolescent morbidity and mortality. We aimed to ascertain the epidemiology of adolescent trauma to inform prevention strategies.MethodsData were abstracted from TARN (Trauma Audit Research Network) from English sites over a 10-year period (2008–2017). Adolescents were defined as 10–24 completed years. Descriptive statistical analysis was used in this study.ResultsThere were 40 680 recorded cases of adolescent trauma. The majority were male (77.3%) and aged 16–24 years old (80.5%). There was a 2.6-fold increase during the study time frame (p<0.0001) in the total annual number of cases reported to TARN. To account for increasing hospital participation, the unit trauma cases per hospital per year was used, noting an increasing trend (p=0.048). Road traffic collision (RTC) was the leading cause of adolescent trauma (50.3%). Pedestrians (41.2%) and cyclists (32.6%) were more prevalent in the 10–15 year group, while drivers (22.9%) and passengers (17.8%) predominated in the 16–24 year group. Intentional injury was reported in 20.7% (alleged assault in 17.2% and suspected self-harm in 3.5%). This was more prevalent in the 16–24 year group. The proportion of trauma reported due to violence has increased with stabbings increasing from 6.9% in 2008 to 10.2% in 2017 (p<0.0001). Evidence of alcohol or drug use was recorded in 20.1% of cases. There was an increase in the number treated in major trauma centres (45.7% 2008 vs 63.5% 2017, p<0.0001). Trauma was more likely to occur between 08:00 and 00:00, at weekends and between April and October. Overall mortality rate was 4.1%. Those with a known psychiatric diagnosis had a higher mortality (6.3% vs 4.4%, p<0.001).ConclusionsRTCs and intentional injuries are leading aetiologies. Healthcare professionals and policy-makers need to prioritise national preventative public health measures and early interventions to reduce the incidence of trauma in this vulnerable age group.

show abstract

Section: Discussionmentioning

confidence: 98%

Epidemiology of adolescent trauma in England: a review of TARN data 2008–2017

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Data from 103 German trauma centres also revealed that most common causes of injury in children were traffic related accidents, followed by falls (Buschmann et al, 2008). Study from 1511 Australian children also showed that motor vehicle collisions were the commonest cause of injury, followed by "struck by/ collisions with an object or person" (Beck et al, 2018). On the other hand, a study from Varanasi, in one of the largest trauma centres in India, reported falls to be the commonest cause of injury among children (Kunwar et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…However, we excluded patients who were admitted directly in the neurosurgery and orthopaedic departments. Data from the German and the Australian cohort showed that head injuries were most common among children (Buschmann et al, 2008;Beck et al, 2018). Data from the "Trauma Audit and Research Network" in UK showed that limb injuries were commonest among 24,218 paediatric trauma cases (Bayreuther et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Epidemiological characteristics of child injury in a tertiary paediatric surgical centre in Bangladesh

Chowdhury

Sadia

Khan

et al. 2020

Asian J. Med. Biol. Res

View full text Add to dashboard Cite

While high income countries (HICs) have reduced the mortality from child injury, it is increasing in the low- and middle-income countries (LMICs). However, injury registry and reporting are inconsistent and not well developed in the LMICs. This study aims at describing the epidemiology of child injury in a tertiary paediatric surgical centre in Bangladesh. We retrospectively analysed all patients of injury between 0 and 12 years of age admitted in the Department of Paediatric Surgery, Chattogram Medical College Hospital during January 2017 to June 2020. Analysis was done for the hospital prevalence, age and sex distribution, seasonal variations, mechanism of injury, site of involvement, and mortality from injury. There were a total of 538 patients and male to female ratio was 2.01:1. Hospital prevalence was 6.71%. Mean age was 6.60 ± 3.32 years. School age children were affected more (51.7%); and “6-10 years” age group had the highest number injuries (251 patients, 46.65%). The most common mechanisms of injuries were road-traffic accident (RTA, 35.32%), followed by fall (26.39%) and „stab or cut injury‟ (20.63%). Males experienced more abdominal injuries and females had more perineal injuries (P=0.00). RTA was the commonest mechanism in males (37.05%) and falls were the commonest mechanism in females (32.96%). „Stab or cut injury‟ was the commonest mechanism in infants and toddlers, and RTA was commonest among pre-school and school age children. There were no significant seasonal variations (P=0.09). There were 5.76% intentional injuries. Mortality was 2.60% and major causes of mortality were RTA and animal assaults. Injuries were more prevalent during the mid-childhood with an overall increasing trend with age. Mechanism of injury and site of involvement were different among different age groups and between sexes. Asian J. Med. Biol. Res. September 2020, 6(3): 577-586

show abstract

“…Year of injury, demographics, injury event details, injury diagnoses, injury severity, and other relevant factors were extracted from the VSTR. Demographic data included sex (male, female) and age in years at the time of injury, categorised into four groups [23]: <1 year, 1-5 years, 6-10 years, and 11-15 years. The Australia Bureau of Statistics (ABS) Socio-Economic Indexes for Areas (SEIFA) were accessed, with the Accessibility/Remoteness Index of Australia (ARIA) (0 = regional, 1 = major city) and the quintiles for the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) (low score = greater disadvantage, high score = greater advantage) were included as indicative measures of socioeconomic status and geographic remoteness.…”

Section: Methodsmentioning

confidence: 99%

Identifying Homogeneous Patterns of Injury in Paediatric Trauma Patients to Improve Risk-Adjusted Models of Mortality and Functional Outcomes

Dipnall

Gabbe

Teague

et al. 2020

IJERPH

Self Cite

View full text Add to dashboard Cite

Injury is a leading cause of morbidity and mortality in the paediatric population and exhibits complex injury patterns. This study aimed to identify homogeneous groups of paediatric major trauma patients based on their profile of injury for use in mortality and functional outcomes risk-adjusted models. Data were extracted from the population-based Victorian State Trauma Registry for patients aged 0–15 years, injured 2006–2016. Four Latent Class Analysis (LCA) models with/without covariates of age/sex tested up to six possible latent classes. Five risk-adjusted models of in-hospital mortality and 6-month functional outcomes incorporated a combination of Injury Severity Score (ISS), New ISS (NISS), and LCA classes. LCA models replicated the best log-likelihood and entropy > 0.8 for all models (N = 1281). Four latent injury classes were identified: isolated head; isolated abdominal organ; multi-trauma injuries, and other injuries. The best models, in terms of goodness of fit statistics and model diagnostics, included the LCA classes and NISS. The identification of isolated head, isolated abdominal, multi-trauma and other injuries as key latent paediatric injury classes highlights areas for emphasis in planning prevention initiatives and paediatric trauma system development. Future risk-adjusted paediatric injury models that include these injury classes with the NISS when evaluating mortality and functional outcomes is recommended.

show abstract

Causes and characteristics of injury in paediatric major trauma and trends over time

Cited by 32 publications

References 24 publications

Epidemiology of adolescent trauma in England: a review of TARN data 2008–2017

Epidemiology of adolescent trauma in England: a review of TARN data 2008–2017

Epidemiological characteristics of child injury in a tertiary paediatric surgical centre in Bangladesh

Identifying Homogeneous Patterns of Injury in Paediatric Trauma Patients to Improve Risk-Adjusted Models of Mortality and Functional Outcomes

Contact Info

Product

Resources

About