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Pediatric Trauma in Southwestern Ontario: Linking Data with Injury Prevention Initiatives

Stewart, Tanya Charyk MSc; Grant, Kathrine BSc; Singh, Ram MB, BS, FRCPC; Girotti, Murray MD, BSc, FRCSC, FACS

The Journal of Trauma: Injury, Infection, and Critical Care: October 2004 - Volume 57 - Issue 4 - p 787-794
doi: 10.1097/01.TA.0000140251.14658.31
Original Articles

Background: Our objective was to provide an epidemiologic description of pediatric trauma in SW Ontario using multiple data sets. Injury prevention (IP) initiatives were linked with predominant injury mechanisms to determine whether IP programs were supported by data.

Methods: Descriptive analysis was undertaken for five pediatric age groups (<1 year, 1–4 years, 5–9 years, 10–14 years, 15–19 years) using the Ontario Trauma Registry’s Death Data Set, Comprehensive Data Set (Lead Trauma Hospitals [LTH] patients), and Minimal Data Set (hospital admissions), 1999–2000, for all pediatric patients residing in SW Ontario. National Ambulatory Care Reporting System (NACRS) data from the Children’s Hospital of Western Ontario/London Health Sciences Centre were used to capture the Emergency Room (ER) injury data. Information on IP initiatives for children and youth was gathered through an Internet search, supplemented by a survey.

Results: Injury in SW Ontario resulted in 13,197 ER visits, 1,616 hospital admissions, 70 severe trauma (ISS > 12) cases treated at a LTH and 47 deaths to children and youth. More males than females were injured, with the sex differential more pronounced as age increased. Falls were the leading mechanism for ER visits (37%) and hospital admissions (26%). Recreational injuries represented approximately 30% of injuries to the 10–14 yr age group. As ISS increased, MVCs emerged as an important mechanism, representing 71% of LTH cases and 53% of pediatric injury deaths in SW Ontario. There were 61 pediatric IP programs identified in SW Ontario. Eighty-four percent of programs (51/61) were supported by data, and were related to one of the predominant injury mechanisms.

Conclusions: Injury is a serious problem for children in SW Ontario. Data can be used to identify modifiable risk factors to develop and implement new IP initiatives with the goal of reducing childhood injury and death. There is a need to integrate and link IP programs in SW Ontario for full coverage of all injury mechanisms.

From the Trauma Program, London Health Sciences Centre; the Children’s Hospital of Western Ontario; and The University of Western Ontario, London, Ontario, Canada.

Submitted for publication August 27, 2003.

Accepted for publication June 24, 2004.

Presented at the 2003 meeting of the Trauma Association of Canada, Banff, Alberta, March 28, 2003.

Address for reprints: T. Charyk Stewart, MSc, London Health Sciences Centre, 375 South Street, Room W100, London, Ontario, N6A 4G5;

© 2004 Lippincott Williams & Wilkins, Inc.