Neighborhood Disadvantage and Injury Mechanism, Severity, and Outcomes in Pediatric Trauma

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2024-12-05 DOI:10.1016/j.jpedsurg.2024.162084

Emily K. Myers , Keren Eyal , Jose L. Diaz-Miron , Kaci L. Pickett-Nairne , Jaclyn E. Orehova , Sarah C. Vangi , Mark B. Malham , Lauren R.S. Hill , Kathleen M. Adelgais , Jonathan L. Hills-Dunlap , Marina L. Reppucci , Shannon N. Acker

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引用次数: 0

Abstract

Background

Traumatic injuries remain the leading cause of death in children aged 1–14. Previous research demonstrates a link between lower socioeconomic status (SES) and higher pediatric injury morbidity and mortality. There is scant research exploring the relationship between neighborhood disadvantage and pediatric trauma. This study utilizes Area Deprivation Index (ADI) to understand the relationship between pediatric traumatic injury mechanisms, severity, and outcomes and neighborhood disadvantage.

Methods

We performed a single-center cross-sectional analysis of pediatric trauma patients aged 0–18 presenting to our Level 1 Pediatric Trauma Center from 2016 to 2021. Patients were stratified into quintiles by national ADI. Injury mechanisms and severity markers were analyzed across ADI quintiles. A subset analysis was also performed, comparing complications and outcomes across ADI quintiles for severely injured patients.

Results

Children from areas of higher disadvantage experienced higher rates of injuries related to automobiles, non-accidental trauma (NAT)/assault/neglect, penetrating injuries, and thermal injuries (p < 0.001). Children from areas of low disadvantage incurred more injuries related to sports (p < 0.001) and falls (p = 0.002). Multiple markers of trauma severity increased with increasing neighborhood disadvantage. No differences were found in clinical outcomes in the subset of most severely injured children.

Conclusions

Mechanisms and severity of traumatic injuries among children vary with degree of neighborhood disadvantage. Outcomes did not differ by ADI quintile in the most severely injured children. ADI may be a tool for identifying children at higher risk for certain injury mechanisms and more severe injuries and could be used to target injury prevention interventions to more vulnerable communities.

Type of Study

Retrospective cross-sectional analysis.

Level of Evidence

Level IV.

Abstract Image

查看原文本刊更多论文

儿童创伤的邻里不利因素和损伤机制、严重程度和结局。

背景：创伤性损伤仍然是1-14岁儿童死亡的主要原因。先前的研究表明，较低的社会经济地位（SES）和较高的儿科伤害发病率和死亡率之间的联系。很少有研究探讨邻里不利和儿童创伤之间的关系。本研究利用区域剥夺指数（Area Deprivation Index， ADI）来了解儿童外伤性损伤机制、严重程度、结局与邻里劣势之间的关系。方法：我们对2016年至2021年在我们一级儿科创伤中心就诊的0-18岁儿童创伤患者进行了单中心横断面分析。根据国家ADI将患者分为五分之一。在ADI五分位数中分析损伤机制和严重程度标记物。还进行了一项亚组分析，比较了严重受伤患者在ADI五分位数上的并发症和结果。结果：来自弱势地区的儿童发生车祸、非意外伤害/攻击/忽视、穿透伤和热伤的比例更高。结论：儿童创伤的机制和严重程度随弱势地区的程度而变化。在受伤最严重的儿童中，结果没有ADI五分位数的差异。ADI可能是识别某些伤害机制和更严重伤害风险较高的儿童的工具，并可用于针对更脆弱的社区进行伤害预防干预。研究类型：回顾性横断面分析。证据等级：四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.