Pattern of severe injuries in Spanish children: boys and falls are alarmingly overrepresented

Abstract

Background: Taking into account that injury is one of the main causes of child fatalities in developed countries, and that boys are more likely to suffer it than girls, we have explored a database of pediatric patients with severe injuries to determine whether sex and age influence the pattern of these fatalities, and the magnitude of this. Method:Observational study of the demographic and clinical characteristics of 227 patients from a Spanish pediatric reference hospital, all of them admitted with a diagnosis of trauma.Result: Falls are the most frequent type of trauma (60.7%), followed by pedestrian traffic collisions (15%). Boys are over-represented in falls (72% vs 28% in girls) and pedestrian traffic injuries (61% vs 39 %). In boys, falls are mainly observed in public roads and during leisure activities (53.8%) whereas in girls at home (55.2%). In a logistic regression, sex and age are statistically significant predictors of severe trauma, boys (OR = 1.59) and the adolescent age group (OR = 3.7) showed the highest odds. Conclusion:We have observed a clear gender-biased pattern of injury-related events: falls are the leading cause of injuries, with 2.5 boys for every girl. Falls mostly happened during outdoor leisure activities in boys and at home in girls. Pedestrian traffic injuries also show significant differences between sexes, emphasizing the role of cognitive and cultural factors in children's behavior. 3 WHAT IS ALREADY KNOWN ON THE SUBJECT In 2016 road injuries were the third cause of death among children from 5 to 9 years old in the OCDE countries. Road traffic injuries and falls are the most relevant sources of unintentional trauma.  Injury-related events are gender-biased, with boys suffering more frequent and severe events than girls. But there are few studies indicating whether this sex biased pattern is present in all types of trauma. WHAT THIS STUDY ADDS Sex and age are statistically significant predictors of severe trauma in children. Boys show 2.5 times more severe falls than girls, mainly during outdoor leisure activities. Cognitive and cultural factors may explain the remarkable age differences observed between boys and girls in pedestrian traffic collisions. The relatively high proportion of young girls involved in falls from great heights needs to be contrasted with data from comparable studies, and if this tendency is confirmed, preventive measures must be launched.