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Original article
Causes and characteristics of injury in paediatric major trauma and trends over time
  1. Ben Beck1,
  2. Warwick Teague2,3,4,
  3. Peter Cameron1,5,
  4. Belinda J Gabbe1,6
  1. 1 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  2. 2 Trauma Service, The Royal Children’s Hospital, Melbourne, Victoria, Australia
  3. 3 Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
  4. 4 Surgical Research Group, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
  5. 5 Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
  6. 6 Farr Institute, Swansea University Medical School, Swansea University, Swansea, UK
  1. Correspondence to Dr Ben Beck, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne VIC 3004, Australia; ben.beck{at}monash.edu

Abstract

Objective To investigate causes, characteristics and temporal trends of paediatric major trauma.

Design A 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.

Setting Victoria, Australia.

Results Of 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%.

Conclusions This 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.

  • injury prevention
  • epidemiology

https://doi.org/10.1136/archdischild-2018-315565

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    Footnotes

    • Contributors All authors contributed to the conception of the study. BB conducted the analysis and wrote the first draft. WT, PC and BJG all provided critical editorial input.

    • Funding The Victorian State Trauma Registry (VSTR) is a Department of Health and Human Services, State Government of Victoria and Transport Accident Commission funded project. BB was supported by an Australian Research Council Discovery Early Career Researcher Award Fellowship (DE180100825). WT’s role as Director of Trauma Services at The Royal Children’s Hospital, Melbourne, is supported by a grant from the Royal Children’s Hospital Foundation. PC was supported by a National Health and Medical Research Council (NHMRC) Practitioner Fellowship (545926). BJG was supported by an Australian Research Council Future Fellowship (FT170100048).

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval The VSTR has Human Research Ethics Committee approval from the Department of Health and Human Services (DHHS) for all 138 trauma-receiving hospitals in Victoria, and the Monash University Human Research Ethics Committee (MUHREC).

    • Provenance and peer review Not commissioned; externally peer reviewed.