Patterns of moderate and severe injury in children after the introduction of major trauma networks.

Objective: To describe the demographics, mechanisms, presentation, injury patterns and outcomes for children with traumatic injuries. Setting: Data collected from the UK’s Trauma and Audit Research Network (TARN). Design and Patients: The demographics, mechanisms of injury and outcomes were described for children with moderate and severe injuries admitted to the Major Trauma Network in England between 2012 and 2017. Intervention: N/A Results: Data regarding 9851 children were collected. Most (69%) were male. The median age was 6.4 (SD 5.2) years, but infants aged 0.1 years (36.5 days) were the most frequently injured of all ages (0 to 15 years); 447 (36.0%) of injuries in infants aged <1 year were from suspected child abuse. Most injuries occurred in the home, from falls of <2 metres, after school hours, at weekends and during the summer. The majority of injuries were of moderate severity (median ISS 9.0, SD 8.7). The limbs and pelvis, followed by the head were most frequently, the most severely injured body part. Ninety two percent were discharged home and 72.8% made a ‘good recovery’ according to the Glasgow Outcome Scale. 3.1% of children died, their median age was 7.0 years (SD 5.8), but infants were the most common fatally injured group. Conclusions: A common age of injury and mortality was infants aged <1 year. Accident prevention strategies need to focus on the prevention of non-accidental injuries in infants. Trauma services need to be organised to accommodate peak presentation times, which are after school, weekends and the summer.