The Incidence of Injuries Among 87,000 Massachusetts Children and Adolescents: Results of the 1980-81 Statewide Childhood Injury Prevention Program Surveillance System

Gallagher, Susan Scavo; Finison, Karl; Guyer, Bernard; Goodenough, Sandra

doi:10.1097/00004630-198607000-00013

Cited by 48 publications

(69 citation statements)

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“…The data from the present study demonstrates that males are more likely than females to suffer a Crotaline snakebite that is subsequently treated with antivenom (2.1:1). This finding is consistent with previous studies of overall injury ratios and studies of snakebites where the male:female snakebite ratio has ranged from 1.4:1 to 2.8:1 [3,[5][6][7][8].…”

Section: Discussionsupporting

confidence: 92%

“…For instance, in studies of pediatric injury rates, males are injured more commonly. A study of 87,000 Massachusetts children and adolescents demonstrated a male:female injury ratio of 1.66:1 [3]. While the etiologies of this difference are likely multifactorial, sex-specific differences in risk-taking behaviors have been implicated.…”

Section: Discussionmentioning

confidence: 99%

“…Particularly in adolescents, sex is significantly related to the incidence of unintentional injury, and males are more susceptible to injury than females [3]. There are sex differences between the types (such as substance abuse, sports, and employment) and frequency of risky behavior [4].…”

Section: Introductionmentioning

confidence: 99%

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Pediatric sex group differences in location of snakebite injuries requiring antivenom therapy

et al. 2007

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Objective: The objective of this study is to examine the patterns of snakebite injury in pediatric patients that require antivenom therapy and to evaluate whether and when sex group differences exist.Methods: We performed a nationwide, multicenter, retrospective evaluation of 24 regional poison centers from 2002 and through 2004 of data for antivenom therapy for Crotaline snakebites. Data points abstracted included the age of the victim, sex of the victim, and location of bite. We calculated contingency tables of the data with statistical significance by Fisher's exact test.Results: We evaluated 204 records that involved pediatric patients; 3 of the patients had no recorded age. In 16 of the records, the bite location was not documented (2 children and 1 unknown age) or was listed as head/neck (1 child). These records were not included in the data analysis. There were bites in 136 males and 65 females. Males were more likely than females to suffer an injury to the upper extremity (56.6% vs. 26.2%; p Ͻ 0.01). Males were more likely to suffer injuries to the upper extremity in all age groups (p Ͻ 0.05) except for the group aged 10 through 12 years; in the group aged 10 through 12, we did not see significant differences between the sexes (p ϭ 0.729). Males are more likely to suffer an upper extremity bite with increasing age (p ϭ 0.029), while females showed no significant change in the location of bites (p ϭ 0.223).Conclusion: Male children were more likely than female children to suffer Crotaline snakebites that required antivenom therapy. In this population, significant differences between locations of snakebites were found. Males were more likely than females to be bitten in the upper extremities. This difference appears as early as 1 to 4 years of age.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Pediatric sex group differences in location of snakebite injuries requiring antivenom therapy

et al. 2007

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“…[6][7][8] In infants and toddlers, physical abuse is the cause of 12% to 20% of fractures. 9 Although unintentional fractures are much more common than fractures caused by child abuse, the physician needs to remain aware of the possibility of inflicted injury.…”

Section: Differential Diagnosis Of Fractures Trauma: Child Abuse Versmentioning

confidence: 99%

Evaluating Children With Fractures for Child Physical Abuse

Peréz-Rosselló¹,

Levine²,

Hennrikus³

et al. 2014

Pediatrics

246

162

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Fractures are common injuries caused by child abuse. Although the consequences of failing to diagnose an abusive injury in a child can be grave, incorrectly diagnosing child abuse in a child whose fractures have another etiology can be distressing for a family. The aim of this report is to review recent advances in the understanding of fracture specificity, the mechanism of fractures, and other medical diseases that predispose to fractures in infants and children. This clinical report will aid physicians in developing an evidence-based differential diagnosis and performing the appropriate evaluation when assessing a child with fractures. Pediatrics 2014;133:e477-e489 INTRODUCTIONFractures are the second most common injury caused by child physical abuse; bruises are the most common injury. 1 Failure to identify an injury caused by child abuse and to intervene appropriately may place a child at risk for further abuse, with potentially permanent consequences for the child. 2-4 Physical abuse may not be considered in the physician' s differential diagnosis of childhood injury because the caregiver may have intentionally altered the history to conceal the abuse. 5 As a result, when fractures are initially evaluated, a diagnosis of child abuse may be missed. 3 In children younger than 3 years, as many as 20% of fractures caused by abuse may be misdiagnosed initially as noninflicted or as attributable to other causes. 3 In addition, fractures may be missed because radiography is performed before changes are obvious or the radiographic images are misread or misinterpreted. 2 However, incorrectly diagnosing physical abuse in a child with noninflicted fractures has serious consequences for the child and family. To identify child abuse as the cause of fractures, the physician must take into consideration the history, the age of the child, the location and type of fracture, the mechanism that causes the particular type of fracture, and the presence of other injuries while also considering other possible causes. DIFFERENTIAL DIAGNOSIS OF FRACTURES Trauma: Child Abuse Versus Noninflicted InjuriesFractures are a common childhood injury and account for between 8% and 12% of all pediatric injuries. [6][7][8] In infants and toddlers, physical FROM THE AMERICAN ACADEMY OF PEDIATRICSGuidance for the Clinician in Rendering Pediatric Care by guest on May 11, 2018 http://pediatrics.aappublications.org/ Downloaded from abuse is the cause of 12% to 20% of fractures. 9 Although unintentional fractures are much more common than fractures caused by child abuse, the physician needs to remain aware of the possibility of inflicted injury. Although some fracture types are highly suggestive of physical abuse, no pattern can exclude child abuse. 10,11 Specifically, it is important to recognize that any fracture, even fractures that are commonly noninflicted injuries, can be caused by child abuse. Certain details that can help the physician determine whether a fracture was caused by abuse rather than unintentional injury include the hist...

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“…1 A study of injury incidence over a one-year period in Massachusetts found that 96% of injuries in children did not result in death; the child was treated and released from an emergency department (ED). 4 More than half of emergency visits for children ages 5-14 years are for injury, and injuries account for more than 11 million emergency visits each year by U.S. children. [5][6][7] The home has been implicated as a leading location of injury for U.S. children.…”

mentioning

confidence: 99%

Residential Injuries in U.S. Children and Adolescents

et al. 2005

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SYNOPSISObjectives. Injuries are the leading cause of death and disability for U.S. children, but little research exists on injury in the home environment. The purpose of this study was to estimate the rate and severity of and trends in unintentional residential injury for U.S. children Ͻ20 years for 1993-1999.Methods. Data on emergency department (ED) visits were obtained from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Rates and 95% confidence intervals (CIs) were calculated using SUDAAN. Chi-square analysis was used to test for differences among proportions. Time trends were analyzed using linear regression.Results. Residential injuries accounted for an average of 4.01 million (95% CI 3.50 million, 4.56 million) ED visits each year for U.S. children, representing 39% of unintentional injury ED visits. There were an average of 531,000 (95% CI 456,000, 606,000) visits with moderate-to-severe injuries, resulting in 73,680 (95% CI 59,715, 87,645) hospital admissions annually. The rate of residential injury visits (excluding unknown locations) was 5.6 per 100 (95% CI 4.9 per 100, 6.4 per 100). The visit rates for children Ͻ5 years of age were higher than those for children Ͼ9 years (pϽ0.0001). Males had a higher rate of visits than females (pϭ0.01). Falls were the leading mechanisms, resulting in 1.5 million ED visits per year (95% CI 1.3 million, 1.8 million). Residential injury rates decreased by 28% over time (pϽ0.02), from 6.3 per 100 (95% CI 3.4, 9.2) in 1993 to 4.5 per 100 (95% CI 2.3, 6.7) in 1999.Conclusions. The predominant location of injury for U.S. children is the home, accounting for 4.01 million ED visits and more than 70,000 hospitalizations each year. Efforts targeted to the home environment are needed to reduce morbidity and mortality from unintentional injury in U.S. children.

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The Incidence of Injuries Among 87,000 Massachusetts Children and Adolescents: Results of the 1980-81 Statewide Childhood Injury Prevention Program Surveillance System

Cited by 48 publications

References 0 publications

Pediatric sex group differences in location of snakebite injuries requiring antivenom therapy

Pediatric sex group differences in location of snakebite injuries requiring antivenom therapy

Evaluating Children With Fractures for Child Physical Abuse

Residential Injuries in U.S. Children and Adolescents

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