Causes and consequences of pedestrian injuries in children.

Abstract

Pedestrian-car collisions are in motorised countries one of the leading causes of unintentional-injury-related death and morbidity among children. The objective of this study was to assess correlations between the mode and the severity or post-traumatic sequels of the injury. A 12-year (1989-2001) retrospective study of children aged 0-16 years injured in pedestrian-motor-vehicle collisions was undertaken. An anonymous survey with questionnaires completed by families was conducted. In this time period, 501 children (average age: 7.9 years) were injured. The lack of visibility of the vehicle (45%) and/or the pedestrian (39%) was the leading cause of injury. The mean injury severity score was 6.0 (1-75) and the mortality rate was 0.8% ( n=4, injury severity scores 47, 75, 75, 75). In this study, 217 questionnaires were analysed. When the children were injured, 37% of them were alone, 32.3% were in the presence of accompanying adults, and 24.0% were in the presence of other children. The latter group suffered the highest injury severity score ( P=0.016). Positive correlations were noted between injury severity score and impact speed ( r=0.31, P<0.001) and the distances that the children were thrown off or transported on the vehicle front ( r=0.29, P<0.001). Physical sequels were reported by 27% of the families, and 23% noted psychological disturbances. A positive correlation was noted between impact speed and the occurrence of physical sequels ( P<0.001). The number of deformed parts per vehicle was correlated to the occurrence of behavioural disturbances ( P<0.004). The incidence of post-traumatic sequels seems to be associated with higher speed at impact, lack of braking attempts, and higher numbers of vehicle parts deformed.