title: The impact of pediatric trauma in the Amish community.
abstract: OBJECTIVE
  To describe the epidemiology of trauma in Amish children and to determine differences in treatment and outcome related to injury mechanism.
  
  
  METHODS
  In this retrospective review, data were collected on all Amish children with trauma requiring hospital admission. Demographic, interventional, and outcome data were collected. Categorical outcomes were compared by using chi-square, logistic regression, or Fisher exact test; continuous outcomes were compared with analysis of variance.
  
  
  RESULTS
  A total of 135 trauma admissions were studied. There was a significant difference of proportion of injury by month (P < .01). The most common mechanisms of injury were falls (39%), buggy versus motor vehicle accidents (MVA; 16%), and animal injuries (14%). A total of 41% of patients required operative procedures, and 50% of subjects required intensive care. Animal injuries and buggy versus MVA were significantly associated with a requirement for surgery, increased length of stay, and increased severity (all P < .01). The overall mortality rate was 3%. There were significant associations between mechanism of injury and outcome scores (P < .05) and hospital charges (P < .05).
  
  
  CONCLUSIONS
  The spectrum of traumatic injuries is unique among Amish children. These injuries contribute significantly to morbidity and mortality and impose a large monetary burden on the Amish community. Education may decrease the incidence of these events.
authors.affiliation: Department of Pediatrics, Division of Pediatric Surgery, Pennsylvania State University College of Medicine, Hershey, 17033, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Vitale
authors.forename: Susan
authors.initials: S
authors.lastname: Rzucidlo
authors.forename: Michele L
authors.initials: ML
authors.lastname: Shaffer
authors.forename: Gary D
authors.initials: GD
authors.lastname: Ceneviva
authors.forename: Neal J
authors.initials: NJ
authors.lastname: Thomas
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000383:Agriculture; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000706:statistics & numerical data; D003952:Diagnostic Imaging / Q000706:statistics & numerical data; D005006:Ethnicity; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D010414:Pennsylvania / Q000453:epidemiology; D010507:Periodicity; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D014186:Transportation; D014947:Wounds and Injuries / Q000453:epidemiology*