Mechanisms of paediatric injury: an 11-year review of injury trends from the National Trauma Data Bank.

Background/purpose: Unintentional injuries are the leading cause of death among children and adolescents. The objective of this study was to describe temporal trends of paediatric traumatic injury over an 11-year period by mechanism of injury (MOI), age, sex, race and ethnicity, injury severity and hospital discharge disposition.

Methods: The National Trauma Data Bank was queried to identify paediatric patients (1-17 years old) injured from 2012 to 2022. Two-sided non-parametric Mann-Kendall trend tests were used to evaluate temporal trends of MOI for all patients and within demographic groups.

Results/outcomes: Over the 11-year period, 1 092 308 injury records met study inclusion criteria and had complete demographic and MOI data. Across all patients, there was a significant increase in bites and stings, cut/pierce injuries and firearm injuries, whereas there were decreasing trends in pedestrian and other blunt injuries over time. There was a significant increase in injury over time for Black, Hispanic or Latino, and Pacific Islander patients and those 5-9 years old. The MOIs with the highest injury severity and in-hospital mortality were firearm, pedestrian and motor vehicle transportation occupant injuries.

Conclusions: Though a few MOIs increased for all paediatric patients in the study period, disparities persist for several specific populations. As such, injury prevention strategies should be tailored based on age, sex and race or ethnicity, and relevant education and resources should be provided to both children and their adult guardians. Future research should consider additional socioeconomic and community-based characteristics.