• Arch. Dis. Child. · Mar 2019

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

    • Ben Beck, Warwick Teague, Peter Cameron, and Belinda J Gabbe.
    • Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
    • Arch. Dis. Child. 2019 Mar 1; 104 (3): 256-261.

    ObjectiveTo investigate causes, characteristics and temporal trends of paediatric major trauma.DesignA retrospective review of paediatric major trauma (<16 years of age) was conducted using data from the population-based Victorian State Trauma Registry from 2006 to 2016. Temporal trends in population-based incidence rates were evaluated using Poisson regression.SettingVictoria, Australia.ResultsOf the 1511 paediatric major trauma patients, most were male (68%), had sustained blunt trauma (87%) and had injuries resulting from unintentional events (91%). Motor vehicle collisions (15%), struck by/collisions with an object or person (14%) and low falls (13%) were the leading mechanisms of injury. Compared with those aged 1-15 years, a greater proportion of non-accidental injury events were observed in infants (<1 year) (32%). For all patients, isolated head injury (29%), other/multitrauma (27%) and head and other injuries (24%) were the most prevalent injury groups. The incidence of paediatric major trauma did not change over the study period (incidence rate ratio (IRR)=0.97; 95% CI 0.92 to 1.02; p=0.27), which was consistent in all age groups. There was a 3% per year decline in the incidence of transport events (IRR=0.97; 95% CI 0.94 to 0.99; p=0.005), but no change in the incidence of falls of any type (IRR=1.01; 95% CI 0.97 to 1.04; p=0.70) or other events (IRR=1.00; 95% CI 0.97 to 1.02; p=0.79). The overall in-hospital mortality rate was 7.2%.ConclusionsThis study demonstrated no change in the incidence of paediatric major trauma over an 11-year period. Given the potential lifelong impacts of serious injury in children, additional investment and coordination of injury prevention activities are required.© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

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