title: Severe childhood injuries and poisoning in a densely populated city: where do they occur and what type?
abstract: OBJECTIVE
  The aim of this study was to review the patterns of severe childhood injuries and poisoning necessitating pediatric intensive care in a regional trauma center.
  
  
  METHODS
  We reviewed discharge data of all children who were hospitalized for severe injuries and poisoning at the pediatric intensive care unit of a teaching hospital between October 2002 and December 2008.
  
  
  RESULTS
  There were 86 patients (males/females, 2:1). Road traffic injuries (n = 19), falls (n = 17), and scalds (n = 13) were the 3 leading categories and accounted for 57% of these pediatric intensive care unit admissions. Injuries more commonly occurred indoor (63%), and victims of indoor accidents were younger (median age, 2.6 vs 8.4 years; P < .0001), with scalds, poisoning, and foreign body aspiration being predominant, whereas road traffic accidents predominated in outdoor accidents. As a risk factor, premorbid neurodevelopmental conditions such as mental retardation, convulsion disorder, or cerebral palsy were only present in indoor accidents. Children in outdoor injuries were generally healthy. Both groups were associated with significant morbidity (mechanical ventilation in 60%, inotrope use in 20%, anticonvulsants in 24%, and neurological/neurosurgical supports in 49%). Comparing the 3 most common categories of patients, there were significant differences in the median age, requirement of neurological/neurosurgical supports, and median hospital stay. Although not requiring neurological/neurosurgical supports, scalds injuries involved the youngest age group and required the longest hospital stay.
  
  
  CONCLUSIONS
  The causes of severe childhood injuries are heterogeneous. Cardiopulmonary or neurological/neurosurgical supports are often required. These injuries more commonly occur indoor and involve toddlers with underlying neurodevelopmental conditions. These findings have important implications and serve to heighten public awareness especially on home safety measures in the prevention of childhood accidents.
authors.affiliation: Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. ehon@cuhk.edu.hk
authors.forename: Kam-Lun
authors.initials: KL
authors.lastname: Hon
authors.forename: Ting-Fan
authors.initials: TF
authors.lastname: Leung
authors.forename: Kam-Lau
authors.initials: KL
authors.lastname: Cheung
authors.forename: Siu-Ying Angel
authors.initials: SY
authors.lastname: Nip
authors.forename: Judy
authors.initials: J
authors.lastname: Ng
authors.forename: Tai-Fai
authors.initials: TF
authors.lastname: Fok
authors.forename: Pak-Cheung
authors.initials: PC
authors.lastname: Ng
mesh_terms: D000056:Accident Prevention; D000059:Accidents / Q000401:mortality / Q000706:statistics & numerical data*; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002947:Cities; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D011041:Poisoning / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014504:Urban Health; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology* / Q000401:mortality