title: Traumatic peripheral nerve injuries in children: epidemiology and socioeconomics.
abstract: OBJECTIVE
  Despite the negative effects of peripheral nerve injuries (PNIs) on long-term population health, their true prevalence among pediatric trauma patients is under debate. The authors investigated the prevalence of PNIs among children involved in trauma and investigated associations between PNIs and several patient characteristics.
  
  
  METHODS
  The authors performed a retrospective cohort study of pediatric trauma patients who were registered in the National Trauma Data Bank from 2009 through 2011 and who fulfilled the study inclusion criteria. They used regression techniques to investigate the association of demographic and socioeconomic factors with the rate of PNIs among these patients.
  
  
  RESULTS
  Of the 245,470 study patients, 50,211 were involved in motor vehicle crashes, 3380 in motorcycle crashes, 20,491 in bicycle crashes, 18,262 in pedestrian accidents, 26,294 in other crashes (mainly involving all-terrain vehicles and snowmobiles), and 126,832 in falls. The respective prevalence of PNIs was 0.66% for motor vehicle crashes, 1% for motorcycle crashes, 0.38% for bicycle crashes, 0.42% for pedestrian accidents, 0.79% for other crashes, and 0.52% for falls. Multivariate logistic regression analysis demonstrated that the following were associated with an increased incidence of PNIs: increased patient age (OR 1.10, 95% CI 1.01-1.20), higher Injury Severity Score (OR 1.10, 95% CI 1.01-1.20), elevated systolic blood pressure at arrival at the emergency room (OR 1.10, 95% CI 1.01-1.20), and increased number of trauma surgeons at the institution (OR 1.10, 95% CI 1.01-1.20). The following were associated with lower incidence of PNIs: female sex (OR 0.94, 95% CI 0.87-1.02), rural hospitals (OR 0.94, 95% CI 0.87-1.02), and urban nonteaching hospitals (OR 0.94, 95% CI 0.87-1.02).
  
  
  CONCLUSIONS
  PNIs are more common than previously identified for the pediatric trauma population. These injuries are associated with older age and increased severity of the overall injury.
authors.affiliation: Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio;
authors.forename: Symeon
authors.initials: S
authors.lastname: Missios
authors.forename: Kimon
authors.initials: K
authors.lastname: Bekelis
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spinner
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D059348:Peripheral Nerve Injuries / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology* / Q000503:physiopathology; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: GCS = Glasgow Coma Scale; ISS = Injury Severity Score; NTDB = National Trauma Data Bank; National Trauma Data Bank; PNI = peripheral nerve injury; pediatric trauma patients; peripheral nerve injury