Where to start? Injury prevention priority scores in Canadian children

J Pediatr Surg. 2019 May;54(5):968-974. doi: 10.1016/j.jpedsurg.2019.01.030. Epub 2019 Jan 31.

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.

Keywords: Injury prevention; Injury prevention prioritization; Pediatric; Priority scores; Trauma.

MeSH terms

  • Accidental Falls / mortality
  • Accidental Falls / statistics & numerical data
  • Adolescent
  • Asphyxia / mortality
  • Canada / epidemiology
  • Child
  • Child, Preschool
  • Drowning / mortality
  • Fires / statistics & numerical data
  • Health Care Costs / statistics & numerical data*
  • Health Knowledge, Attitudes, Practice*
  • Health Resources / statistics & numerical data*
  • Hospitalization / economics
  • Humans
  • Infant
  • Infant, Newborn
  • Injury Severity Score
  • Retrospective Studies
  • Self-Injurious Behavior / complications
  • Self-Injurious Behavior / epidemiology
  • Wounds and Injuries / economics
  • Wounds and Injuries / etiology*
  • Wounds and Injuries / mortality*
  • Wounds and Injuries / prevention & control
  • Young Adult