Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children
Background: Paediatric trauma system development in Alaska is complicated by a vast geographic coverage area, wide regional variations in environment and culture, and a lack of available published data. Objective: To provide a detailed description of paediatric trauma mechanisms, high-risk injury pa...
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ftdoajarticles:oai:doaj.org/article:38032960456344c2a8a13db4a3bc3f73 2023-05-15T15:14:26+02:00 Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children Christopher W. Snyder Oliver J. Muensterer Frank Sacco Shawn D. Safford 2014-08-01T00:00:00Z https://doi.org/10.3402/ijch.v73.25066 https://doaj.org/article/38032960456344c2a8a13db4a3bc3f73 EN eng Taylor & Francis Group http://www.circumpolarhealthjournal.net/index.php/ijch/article/download/25066/pdf_1 https://doaj.org/toc/2242-3982 2242-3982 doi:10.3402/ijch.v73.25066 https://doaj.org/article/38032960456344c2a8a13db4a3bc3f73 International Journal of Circumpolar Health, Vol 73, Iss 0, Pp 1-7 (2014) Alaska injury epidemiology youth resource utilization Arctic medicine. Tropical medicine RC955-962 article 2014 ftdoajarticles https://doi.org/10.3402/ijch.v73.25066 2022-12-31T01:30:54Z Background: Paediatric trauma system development in Alaska is complicated by a vast geographic coverage area, wide regional variations in environment and culture, and a lack of available published data. Objective: To provide a detailed description of paediatric trauma mechanisms, high-risk injury patterns and outcomes in Alaska. Design: This retrospective study included all children aged 17 years or younger in the State of Alaska Trauma Registry database admitted with traumatic injury between 2001 and 2011. Each injury record was reviewed individually and assigned a mechanism based on Centers for Disease Control E-codes. Geographic definitions were based on existing Emergency Medical Services regions. Mechanisms were compared by geographic region, patient demographics, injury characteristics and outcome. Subgroup analysis of fatal injuries was performed to identify causes of death. Results: Of 5,547 patients meeting inclusion criteria, the most common mechanisms of injury were falls (39%), motor vehicle collisions (10%) and all-terrain vehicle (ATV) accidents (9%). The overall case fatality rate was 2%. Mechanisms with the greatest risk of death were gunshot wounds (21%), pedestrians struck by motorized vehicles (9%) and motor vehicle collisions (5%). These 3 mechanisms accounted for 15% of injuries but 60% of deaths in the overall cohort. Injury patterns involving combined central nervous system (CNS) and torso injuries were unusual but especially lethal, occurring in 3% of patients but carrying a case fatality rate of 18%. Although the distribution of mechanisms was generally similar for each geographic region, ATV and snowmobile injuries were significantly more common in remote areas (23% remote vs. 7% non-remote, p < 0.0001). Conclusions: Mechanisms of paediatric trauma in Alaska have widely varying impacts on outcome and show some variation by region. Highest-risk mechanisms include gunshot wounds and motorized vehicle-related accidents. Prevention efforts should give special attention to CNS injury ... Article in Journal/Newspaper Arctic Circumpolar Health International Journal of Circumpolar Health Alaska Directory of Open Access Journals: DOAJ Articles Arctic International Journal of Circumpolar Health 73 1 25066 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Alaska injury epidemiology youth resource utilization Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
Alaska injury epidemiology youth resource utilization Arctic medicine. Tropical medicine RC955-962 Christopher W. Snyder Oliver J. Muensterer Frank Sacco Shawn D. Safford Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children |
topic_facet |
Alaska injury epidemiology youth resource utilization Arctic medicine. Tropical medicine RC955-962 |
description |
Background: Paediatric trauma system development in Alaska is complicated by a vast geographic coverage area, wide regional variations in environment and culture, and a lack of available published data. Objective: To provide a detailed description of paediatric trauma mechanisms, high-risk injury patterns and outcomes in Alaska. Design: This retrospective study included all children aged 17 years or younger in the State of Alaska Trauma Registry database admitted with traumatic injury between 2001 and 2011. Each injury record was reviewed individually and assigned a mechanism based on Centers for Disease Control E-codes. Geographic definitions were based on existing Emergency Medical Services regions. Mechanisms were compared by geographic region, patient demographics, injury characteristics and outcome. Subgroup analysis of fatal injuries was performed to identify causes of death. Results: Of 5,547 patients meeting inclusion criteria, the most common mechanisms of injury were falls (39%), motor vehicle collisions (10%) and all-terrain vehicle (ATV) accidents (9%). The overall case fatality rate was 2%. Mechanisms with the greatest risk of death were gunshot wounds (21%), pedestrians struck by motorized vehicles (9%) and motor vehicle collisions (5%). These 3 mechanisms accounted for 15% of injuries but 60% of deaths in the overall cohort. Injury patterns involving combined central nervous system (CNS) and torso injuries were unusual but especially lethal, occurring in 3% of patients but carrying a case fatality rate of 18%. Although the distribution of mechanisms was generally similar for each geographic region, ATV and snowmobile injuries were significantly more common in remote areas (23% remote vs. 7% non-remote, p < 0.0001). Conclusions: Mechanisms of paediatric trauma in Alaska have widely varying impacts on outcome and show some variation by region. Highest-risk mechanisms include gunshot wounds and motorized vehicle-related accidents. Prevention efforts should give special attention to CNS injury ... |
format |
Article in Journal/Newspaper |
author |
Christopher W. Snyder Oliver J. Muensterer Frank Sacco Shawn D. Safford |
author_facet |
Christopher W. Snyder Oliver J. Muensterer Frank Sacco Shawn D. Safford |
author_sort |
Christopher W. Snyder |
title |
Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children |
title_short |
Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children |
title_full |
Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children |
title_fullStr |
Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children |
title_full_unstemmed |
Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children |
title_sort |
paediatric trauma on the last frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in alaskan children |
publisher |
Taylor & Francis Group |
publishDate |
2014 |
url |
https://doi.org/10.3402/ijch.v73.25066 https://doaj.org/article/38032960456344c2a8a13db4a3bc3f73 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic Circumpolar Health International Journal of Circumpolar Health Alaska |
genre_facet |
Arctic Circumpolar Health International Journal of Circumpolar Health Alaska |
op_source |
International Journal of Circumpolar Health, Vol 73, Iss 0, Pp 1-7 (2014) |
op_relation |
http://www.circumpolarhealthjournal.net/index.php/ijch/article/download/25066/pdf_1 https://doaj.org/toc/2242-3982 2242-3982 doi:10.3402/ijch.v73.25066 https://doaj.org/article/38032960456344c2a8a13db4a3bc3f73 |
op_doi |
https://doi.org/10.3402/ijch.v73.25066 |
container_title |
International Journal of Circumpolar Health |
container_volume |
73 |
container_issue |
1 |
container_start_page |
25066 |
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1766344884307886080 |