Causes and Characteristics of Children Unintentional Injuries in Emergency Department and Its Implications for Prevention

Abstract

Background: Child unintentional injuries have become a hot topic worldwide, and substantial regional disparities existed in causes and characteristics. To date, limited data are available to investigate the causes and characteristics of child unintentional injuries from hospitals for children in China.Methods: A cross-sectional study was conducted between January 2017 and December 2018 in Shanghai, China. Patients aged <18 years with an unintentional injury presented to the emergency department were enrolled. Demographic information, Pediatric Risk for Mortality III score, and outcome variables were retrieved from electronic health records (EHRs). Frequencies and proportions of categorical variables and means and SDs of continuous variables are presented. Chi-square test and Student's t-test were used for the comparison between groups, as appropriate. Logistic regression analysis was used to estimate potential risk factors for admission to the hospital.Results: A total of 29,597 cases with unintentional injuries were identified between January 2017 and December 2018, with boys vs. girls ratio of 1.75. Preschool children account for approximately two-thirds of unintentional injuries in the emergency department. A distinctive pattern of mechanisms of unintentional injuries between gender was documented, and sports injury was significantly higher in boys than in girls (10.2 vs. 7.8%). Compared with Canadian Emergency Department Triage and Acuity Scale (CTAS) Grade 3 patients, Grade 2 [odds ratio (OR) = 2.99, 95% CI = 1.93–4.63, P < 0.001] and Grade 1 (OR = 74.85, 95% CI = 12.93–433.14, P < 0.001) patients had higher risk of inhospital admission. For causes of injuries, compared with falling, foreign body and poison had a lower risk of inhospital admission, while transport injury (OR = 1.31, 95% CI = 1.07–1.59, P = 0.008) and high fall injury (OR = 2.58. 95% CI =1.48–4.49, P < 0.001) had a significantly higher risk of admission.Conclusions: There was a significant relationship between age-groups and unintentional injuries between gender, with decreased injuries among girls growing up older. Preventive measures should be taken to reduce transport injury and high fall injury, which had a significantly higher risk of admission.

Epidemiology, patterns, and mechanisms of pediatric trauma: a review of 12,508 patients

“…In terms of injuries, all deaths associated with RTA were caused by severe brain injury. This goes in line with most studies saying that the head is the most vulnerable body part, especially in young children [11,12,17,26]. In the present study, the head was the most common body part for lacerations and second most for bruises.…”

“…In fact, even at the age of 11-14 years, a slight decrease in injuries due to RTA is found. Gong et al showed similar results with the highest incidence of RTA at the ages between 3 and 6 [26]. The reason for this is probably that many studies include children and adolescents up to 18 or 20 years of age.…”

Unintentional injuries of children and adolescents treated in emergency medical services: A cross-sectional study

“…The predominance of the male gender according to the causes of unintentional injuries is also suggested in other studies and WHO reports. 1,3,10 The reason boys are more prone to injury is explained by previously conducted research that indicates that sex differences might be the result of biological factors, 21 a more dynamic lifestyle, less controlled behaviour 10 and a higher level of physical activity and different patterns of behaviour compared to girls. 22 Boys are more at risk of unintentional injuries irrespective of the injury mechanism.…”

“…23 The results obtained after analysing injuries according to body regions showed that head injuries were the most dominant ones in all age groups, with children younger than 1 year affected the most, which is in accordance with previous studies. 1,24 Young children are more likely to suffer head injuries than older children and one of the reasons is the size of the child's head, the soft and elastic bones of the skull and the weaker supporting structures of the neck, that all contribute to head impact, which is different from that of an adult. 10 Head injuries are common, with specific characteristics among certain groups, requiring not only individual emergency medical care but prevention strategies on the population level.…”

“…Leading causes were traffic injuries, falls, burns, poisonings and drowning. [1][2][3][4] Children and adolescents account for almost 30 % of the world population. They are particularly vulnerable to injuries due to their active and discovery driven nature in early years and risk-taking behaviour in adolescent years.…”