Pediatric injury patterns by year of age

Purpose: Since trauma is the leading cause of death and disability among children, understanding injury patterns may reduce morbidity and mortality through targeted prevention efforts. The purpose of this study was to identify pediatric injury patterns by year of age using a large national database.

Methods: We searched the National Trauma Database (NTDB) Research Data Set 7.0 for patients aged 0-18 years with the following relevant ICD-9 external-cause-of-injury codes (e-codes). We also reviewed our institutional trauma registry data (1999-2009). Data were analyzed using χ(2) analysis and ANOVA with significance defined as p<0.05.

Results: We identified 354,196 pediatric trauma patients. The leading MOI were motor-vehicle collisions (MVC) for ages 10-18 years and falls for ages 0-9 years. Fire was the second leading MOI among 1-year-olds, but not a major MOI in other age groups. Penetrating trauma was the MOI for 21% of injuries among adolescents with public or no insurance (versus 7.5% adolescents with private insurance). Injury severity scores were highest for children <1 year old and children 14-18 years old. Our review of 1209 patients from our institution yielded additional detail.

Conclusion: MVC and falls remain leading pediatric MOI. In our year-of-age analysis, we found several interesting trends, including a higher-than-expected rate of penetrating trauma. Our findings may support targeted injury prevention efforts.