The Preschool-Aged and School-Aged Children Present Different Odds of Mortality than Adults in Southern Taiwan: A Cross-Sectional Retrospective Analysis

Abstract

Background: This study aimed to profile the epidemiology of injury among preschool-aged and school-aged children in comparison to those in adults. Methods: According to the Trauma Registry System of a level I trauma center, the medical data were retrieved from 938 preschool-aged children (aged less than seven years), 670 school-aged children (aged 7–12 years), and 16,800 adults (aged 20–64 years) between 1 January 2009 and 31 December 2016. Two-sided Pearson’s, chi-squared, and Fisher’s exact tests were used to compare categorical data. A one-way analysis of variance (ANOVA) with the Games-Howell post-hoc test was used to assess the differences in continuous variables among different groups of patients. The mortality outcomes of different subgroups were assessed by a multivariable regression model under the adjustment of sex, injury mechanisms, and injury severity. Results: InFsupppjury mechanisms in preschool-aged and school-aged children were remarkably different from that in adults; in preschool-aged children, burns were the most common cause of injury requiring hospitalization (37.4%), followed by falls (35.1%) and being struck by/against objects (11.6%). In school-aged children, injuries were most commonly sustained from falls (47.8%), followed by bicycle accidents (14%) and being struck by/against objects (12.5%). Compared to adults, there was no significant difference of the adjusted mortality of the preschool-aged children (AOR = 0.9; 95% CI 0.38–2.12; p = 0.792) but there were lower adjusted odds of mortality of the school-aged children (AOR = 0.4; 95% CI 0.10–0.85; p = 0.039). The school-aged children had lower odds of mortality than adults (OR, 0.2; 95% CI, 0.06–0.74; p = 0.012), but such lower odds of risk of mortality were not found in preschool-aged children (OR, 0.7; 95% CI, 0.29–1.81; p = 0.646). Conclusions: This study suggests that specific types of injuries from different injury mechanisms are predominant among preschool-aged and school-aged children. The school-aged children had lower odds of mortality than adults; nonetheless there was no difference in mortality rates of preschool-aged children than adults, with or without controlling for sex, injury mechanisms and ISS. These results highlight the importance of injury prevention, particularly for preschool-aged children in Southern Taiwan.

Impact of Adapting the Abbreviated Injury Scale (AIS)-2005 from AIS-1998 on Injury Severity Scores and Clinical Outcome

“…The study double-coded the injuries for all 7520 consecutively admitted trauma patients during a three-year period between 1 January, 2016, and 31 December, 2018, by two certified specialists who had been trained for coding and experienced for three and ten years, respectively, in trauma registry at Taiwan. The study hospital is a level I trauma center in the Kaohsiung city, Taiwan [18][19][20] and serves around three millions patients in southern Taiwan with another two level I trauma centers [21][22][23][24]. About thirty thousand trauma patients had visited the emergency department of this hospital and, among them, there were around 3600 hospitalizations per year.…”

Early-Life Temperamental Differences as Longitudinal Predictors of Unintentional Injuries

“…Furthermore, the type and the context of children’s injuries vary with age. For instance, poisoning, burns, and drownings are most prevalent in preschool-aged children, while falls most commonly occur among school-aged children ( Agran et al, 2003 ; Peng et al, 2018 ). Not surprisingly, injuries of toddlers and infants mostly appear at home, whereas injuries to school-aged children tend to occur outside of their homes ( Bijttebier et al, 2003 ).…”