Samuel Jessula1, Mark Asbridge2, Rodrigo Romao3, Robert Green4, Natalie L Yanchar5. 1. Division of General Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada. Electronic address: samuel.jessula@mail.mcgill.ca. 2. Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada. 3. IWK Health Centre, Dalhousie University, Division of Pediatric General and Thoracic Surgery, Department of Surgery, Halifax, NS, Canada. 4. Trauma Nova Scotia, Halifax, NS, Canada; Department of Critical Care, Dalhousie University, Halifax, NS, Canada. 5. Department of Surgery, Section of Pediatric Surgery, University of Calgary, Calgary, AB, Canada.
Abstract
PURPOSE: Given limited resources, it is essential to determine which Mechanisms of Injury (MOIs) to prioritize for injury prevention policy and research. We developed objective, evidence-based Injury Prevention Priority Scores (IPPSs) for Canadian children across three prevention perspectives: mortality, injury severity, and resource utilization. METHODS: We performed a retrospective cohort study of all injuries in Canada in individuals aged 0 to 19 years old from 2009 to 2014. For each MOI, an IPPS was calculated as a balanced measure of frequency and either mortality rate, median ICD-10 derived Injury Severity Score (ICISS), or median cost per hospitalization. RESULTS: Of 87,017 injuries, 83,112 were nonfatal hospitalizations, and 3905 were deaths. Overall mortality rate was 0.04 deaths/injury, median ICISS was 0.994 (IQR 0.75-0.996), and median cost per hospitalization was CAD$3262 (IQR $2118-$5001). The top three mechanisms were falls (IPPS 72), intentional self-harm (IPPS 68), and drowning (IPPS 65) for mortality, falls (IPPS73), drowning (IPPS 61), and suffocation (IPPS 61) for injury severity and falls (IPPS 70), fires (IPPS 65), and intentional self-harm (IPPS 60) for resource utilization. CONCLUSION: Falls, if prevented, would provide the most benefit to the largest proportion of the Canadian pediatric population and should be targeted for injury prevention. LEVEL OF EVIDENCE: Level III.
PURPOSE: Given limited resources, it is essential to determine which Mechanisms of Injury (MOIs) to prioritize for injury prevention policy and research. We developed objective, evidence-based Injury Prevention Priority Scores (IPPSs) for Canadian children across three prevention perspectives: mortality, injury severity, and resource utilization. METHODS: We performed a retrospective cohort study of all injuries in Canada in individuals aged 0 to 19 years old from 2009 to 2014. For each MOI, an IPPS was calculated as a balanced measure of frequency and either mortality rate, median ICD-10 derived Injury Severity Score (ICISS), or median cost per hospitalization. RESULTS: Of 87,017 injuries, 83,112 were nonfatal hospitalizations, and 3905 were deaths. Overall mortality rate was 0.04 deaths/injury, median ICISS was 0.994 (IQR 0.75-0.996), and median cost per hospitalization was CAD$3262 (IQR $2118-$5001). The top three mechanisms were falls (IPPS 72), intentional self-harm (IPPS 68), and drowning (IPPS 65) for mortality, falls (IPPS73), drowning (IPPS 61), and suffocation (IPPS 61) for injury severity and falls (IPPS 70), fires (IPPS 65), and intentional self-harm (IPPS 60) for resource utilization. CONCLUSION: Falls, if prevented, would provide the most benefit to the largest proportion of the Canadian pediatric population and should be targeted for injury prevention. LEVEL OF EVIDENCE: Level III.
Authors: Adam M Fontebasso; Sonshire Figueira; Kednapa Thavorn; Peter Glen; Jacinthe Lampron; Maher Matar Journal: Trauma Surg Acute Care Open Date: 2020-12-24