Patterns of injury in children: a population-based approach.

Abstract

We describe the frequency and patterns of injury affecting 96 359 children between 0 and 10 years old and living in Alberta, Canada. This population-based, longitudinal study involved children born in the 3 fiscal years of April 1, 1985 to March 31, 1988, recruited before age 1, and who remained in the study until at least age 5. We used the International Classification of Diseases, Ninth Revision, Clinical Modification chapter-17 diagnostic codes provided by physicians. Codes were grouped into 17 categories; injury episodes were calculated, and age- and gender-specific incidence rates for each category were calculated. The age, pattern, times of greatest risk, and the effect of gender on the type and incidence of injury were determined. Health care administrative data were obtained from all fee-for-service health care venues in Alberta between April 1, 1985 and March 31, 1998 providing services to children registered with the Alberta Health Care Insurance Plan and otherwise meeting entrance criteria. Nearly 84% of children received care for an injury during the study period, and in any given year approximately 21% of the population studied had at least 1 injury. Repeat injury was common (73%), and boys were more likely than girls to be injured and to have repeat injury. The most common injuries were dislocations and sprains, open wounds, and superficial injuries and contusions. Burns, poisoning, intracranial injury, and foreign bodies were the next most common, and fractures were least common. Approximately 10% of injuries were multiple-category injuries. Rates varied greatly by injury category, age, and gender. Hospitalization rates varied in a similar manner and commonly accounted for approximately 10% of all services. Males were most likely to have an injury, and aboriginal children or children who had received welfare at some time were at greatest risk. Administrative data can be used to estimate the incidence of injury in a pediatric population. Distinct patterns of injury occur at different ages. Recurrent injury is common. Almost identical proportions of injury (46%) are treated in emergency departments and physicians' offices.