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Patterns of moderate and severe injury in children after the introduction of major trauma networks
  1. Samantha Jones1,2,3,
  2. Sarah Tyson1,3,
  3. Michael Young3,4,
  4. Matthew Gittins1,3,
  5. Naomi Davis2,3
  1. 1 Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
  2. 2 Department of Trauma and Orthopaedics, Manchester Foundation Trust, Royal Manchester Children’s Hospital, Manchester, UK
  3. 3 Research, Manchester Academic Health Science Centre, Manchester, UK
  4. 4 Faculty of Biology, Medicine and Health, Trauma and Audit Research Network, University of Manchester, Manchester, UK
  1. Correspondence to Samantha Jones, Room 257, Ward 86 Management Offices, 3rd Floor, Royal Manchester Children’s Hospital, Oxford Road, Manchester, M13 9WL; samantha.jones{at}mft.nhs.uk

Abstract

Objective To describe the demographics, mechanisms, presentation, injury patterns and outcomes for children with traumatic injuries.

Setting Data collected from the UK’s Trauma and Audit Research Network.

Design and patients The demographics, mechanisms of injury and outcomes were described for children with moderate and severe injuries admitted to the Major Trauma Network in England between 2012 and 2017.

Results Data regarding 9851 children were collected. Most (69%) were male. The median age was 6.4 (SD 5.2) years, but infants aged 0.1 year (36.5 days) were the most frequently injured of all ages (0–15 years); 447 (36.0%) of injuries in infants aged <1 year were from suspected child abuse. Most injuries occurred in the home, from falls <2 m, after school hours, at weekends and during the summer. The majority of injuries were of moderate severity (median Injury Severity Score 9.0, SD 8.7). The limbs and pelvis, followed by the head, were the most frequently and most severely injured body parts. Ninety-two per cent were discharged home and 72.8% made a ‘good recovery’ according to the Glasgow Outcome Scale. 3.1% of children died, their median age was 7.0 years (SD 5.8), but infants were the most commonly fatally injured group.

Conclusions A common age of injury and mortality was infants aged <1 year. Accident prevention strategies need to focus on the prevention of non-accidental injuries in infants. Trauma services need to be organised to accommodate peak presentation times, which are after school, weekends and the summer.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors ST contributed to the conception, design of the work, analysis/interpretation of the data and produced the manuscript drafts. MY has contributed to the acquisition of the data and data analysis. MG has contributed to data analysis and interpretation of the data. ND has contributed to the conception of the work and interpretation of the data. SJ contributed to the conception, design of the work, analysis/interpretation of the data and produced the manuscript drafts. All authors have been responsible critically appraising the work and approving the final version.

  • Funding This manuscript is an independent research supported by the National Institute for Health Research (HEE/ NIHR ICA Programme Clinical Doctoral Research Fellowship, SJ, ICA-CDRF-2016-02-021).

  • Disclaimer The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

  • Competing interests None declared.

  • Patient consent Not required.

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

  • Data sharing statement Manchester Foundation Trust has a data sharing agreement with TARN, which permits the sharing of anonymised TARN data for research purposes. TARN data must only be viewed/analysed by agreed members of the research team and stored on a University of Manchester/Manchester Foundation Trust computer drive.

  • Collaborators Professor Fiona Lecky, Research Director of the Trauma and Audit Research Network (TARN). The collaborative group are the the TARNlet Committee from the Trauma and Audit Research Network (TARN).

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