Traumatic death in urban children, revisited
J. R. Hall, H. M. Reyes, J. L. Meller and R. J. Stein
Pediatric Trauma Center, Department of Surgery, Cook County Hospital, Chicago, IL.
OBJECTIVE--Trauma is the leading cause of death in children older than 1
year in the United States. We performed an analysis of the causes of death
due to trauma in children in a large urban community to suggest means of
prevention in such communities. We also examined data obtained before and
after the designation of pediatric trauma centers to determine whether this
has made a difference. DATA SOURCES--Records of the Medical Examiner, Cook
County, Illinois, from 1983 through 1988. STUDY SELECTION--The admitting
log was reviewed for all children before their 16th birthday. During the
6-year study period, 3121 autopsies were performed on children, 36.1% of
whom died due to traumatic injuries. We reviewed the records of those
children who died secondary to these injuries. DATA EXTRACTION--Record
review on pediatric trauma deaths as to cause of death, time of death, age,
sex, and any other pertinent information. RESULTS--Of all trauma deaths,
fire was the most common cause of death, followed by motor vehicle-related
injuries, homicides, drownings, and falls. These findings differ from
national statistics. Improvement in outcome was seen following the
designation of general trauma centers, with further improvement seen
following the designation of specific pediatric trauma centers.
CONCLUSIONS--Identification of causes of pediatric trauma death enables us
to suggest methods of prevention. The centralized care of seriously injured
children through the establishment of trauma centers and, specifically,
pediatric trauma centers might help to prevent these deaths. Further study
of pediatric trauma deaths, including hospital and ambulance records, is
needed to improve medical care.
