Injury is the leading cause of death in childhood. Most of these injuries are preventable events. With limited resources, strategies for prevention should target severe injuries and be based on developmental stage. The aim of this study was to characterise mechanisms of severe injuries in children aged 1 to 4 years old.
Methods Retrospective review of trauma registry of two paediatric trauma centres in Quebec between January 1999 and April 2006. The Injury Prevention Priority Score (IPPS) and Injury Severity Score (ISS) assigned a priority rank to mechanisms of severe injuries based on frequency and on severity.
Results A total of 640 children 1 to 4 years old with severe injury were identified. Glasgow coma score (GCS) was 7 or less in 33 patients (5%) and mean length of stay was 6.4 days. There were 15 deaths (2.3%). IPPS identified respectively Fall from height, Motor vehicle injuries, Child abuses, Pedestrians struck by motor vehicle and Cycle injuries as the most important mechanisms. The majority of falls occurred at home, mostly in stairs. Less than 30% of victims of motor vehicle accident were adequately restrained. There were 11 all-terrain vehicle-related injuries as a driver or a passenger even in children less than 4 years of age.
Conclusion This study highlights mechanisms that can be targeted by community prevention programs to fight injuries with the highest mortality and morbidity in 1 to 4 years old children.
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