title: A Retrospective Evaluation of Pediatric Major Trauma Related to Sport and Recreational Activities in Nova Scotia.
abstract: OBJECTIVE
  A small proportion of pediatric sport- and recreation-related injuries are serious enough to be considered "major trauma." However, the immediate and long-term consequences in cases of pediatric major trauma are significant and potentially life-threatening. The objective of this study was to describe the incidence and outcomes of pediatric major traumas related to sport and recreational activities in Nova Scotia.
  
  
  METHODS
  This study was a retrospective case series. Data on major pediatric traumas related to sport and recreational activities on a provincial scope were extracted from the Nova Scotia Trauma Program Registry between 2000 and 2013. We evaluated frequency, type, severity, and outcomes of major traumas. Outcomes assessed included length of hospital stay, admission to a special care unit (SCU), and mortality.
  
  
  RESULTS
  Overall, 107 children aged three to 18 years sustained a major trauma (mean age 12.5 [SD 3.8]; 84% male). Most injuries were blunt traumas (97%). The greatest proportion were from cycling (59, 53%), followed by hockey (8, 7%), skateboarding (7, 7%) and skiing (7, 7%). The Nova Scotia Pediatric Trauma Team was activated in 27% of cases. Mean in-hospital length of stay was five days (SD 5.6), and nearly half (49%) of patients required SCU admission. Severe traumatic brain injury occurred in 52% of cases, and mortality in five cases.
  
  
  CONCLUSIONS
  Over a 13-year period, the highest incidence of pediatric major trauma related to sport and recreational activities was from cycling, followed by hockey. Severe traumatic brain injury occurred in over half of pediatric major trauma patients.
authors.affiliation: *Department of Emergency Medicine,Dalhousie University,Halifax,NS.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Green
authors.affiliation: †Department of Critical Care Medicine,Dalhousie University,Halifax,NS.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Butler
authors.affiliation: ‡Division of Neurosurgery,Dalhousie University,Halifax,NS.
authors.forename: Nelofar
authors.initials: N
authors.lastname: Kureshi
authors.affiliation: §Trauma Nova Scotia,Halifax,NS.
authors.forename: Mete
authors.initials: M
authors.lastname: Erdogan
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D015994:Incidence; D008297:Male; D009674:Nova Scotia / Q000453:epidemiology; D011998:Recreation; D012189:Retrospective Studies; D012621:Seasons; D015599:Trauma Severity Indices
keywords: injuries; pediatrics; sports