Citation

Sarathy A, Benson J, Nguyen K, Amato S, Sajisevi M, Ostby ET. Laryngoscope Investig. Otolaryngol. 2024; 9(4): e1301.

Copyright

(Copyright © 2024, American Laryngological, Rhinological and Otological Society, Publisher John Wiley and Sons)

DOI

10.1002/lio2.1301

PMID

38974603

PMCID

PMC11222705

Abstract

INTRODUCTION: Pediatric head and neck (HN) trauma is an important contributor to pediatric morbidity, resulting in significant downstream consequences. Few studies provide epidemiological predictors of pediatric HN trauma on a national scale. The present study aims to identify risk factors of HN injury and mortality in the pediatric population.

METHODS: A retrospective cohort study was conducted for patients (age <18 years) using the US National Trauma Data Bank (NTDB 2007-2019). Demographic, injury, and physiologic outcome data were analyzed. HN injury was defined as a head or neck Abbreviated Injury Scale (AIS) >0. Logistic regression identified independent predictors of mortality following HN trauma.

RESULTS: Of the 1.42 million pediatric patients analyzed, 44.05% had HN injury. In patients aged 0-4, the most common mechanism was falls (47.67% in this age group) while in ages 14-17, motor vehicle/transport accidents (MVTs) were the most common mechanism (56.06%). Controlling for demographics, comorbidities, and injury severity, HN injury was associated with increased odds of mortality (OR 2.404, 95% CI 1.530-3.778). HN injury mortality was strongly predicted by firearm exposure (OR 11.28, 95% CI 6.074-20.95), age <4 (OR 1.179, 95% CI 1.071-1.299), and self-insured status (OR 1.977, 95% CI 1.811-2.157).

CONCLUSION: NTDB data demonstrate that the percentage of pediatric patients with HN trauma has decreased over the past 12 years although is associated with increased odds of mortality. Age and insurance status predicted mortality from HN trauma, with falls and MVTs being the most common mechanisms of injury. These data have implications for future public health efforts in this patient population. LEVEL OF EVIDENCE: 3.

Language: en

Keywords

pediatric; mortality; falls; head and neck trauma; motor vehicle trauma