title: Pedestrian injuries in children: who is most at risk?
abstract: BACKGROUND
  This study evaluates the demographics of paediatric pedestrian injuries with the aim of identifying the group of children who is most vulnerable and the risk factors for major trauma (MT).
  
  
  METHODS
  Data was extracted from the integrated trauma system of a regional paediatric referral hospital. All paediatric cases involving road traffic accidents from January 2011 to December 2013 were studied. Demographics, injury mechanism, treatment and outcome were evaluated. Patients were categorised as MT or non-MT (NMT) based on their Injury Severity Score, admission to the intensive care unit, type of surgery (e.g. life/limb-saving) and death. Data analysis was done using nonparametric tests and Fisher's exact test.
  
  
  RESULTS
  A total of 261 children were admitted for pedestrian injuries during the study period. The median age was ten years (range 14 months-16 years) and the median weight was 42.4 (range 8.6-93.7) kg. Half (i.e. 50.2%) of the children were primary-schoolers. The majority of the accidents occurred on roads (i.e. 83.1%), between 12 pm and 6 pm (i.e. 52.8%). Among the 261 children, 177 (67.8%) were unaccompanied by an adult at the time of the accident; 17 (6.5%) children sustained MT, while 244 (93.5%) suffered NMT. MT patients were more likely to have lost consciousness (p < 0.001) and been flung (p = 0.001).
  
  
  CONCLUSIONS
  Most paediatric pedestrian injuries involved primary-schoolers walking home from school unaccompanied by adults. This information should inform future road safety campaigns. Being flung and loss of consciousness predicted MT in children who sustained pedestrian injuries.
authors.affiliation: Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore.
authors.forename: Xun Yi Jasmine
authors.initials: XY
authors.lastname: Feng
authors.affiliation: Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore.
authors.forename: Shireen Anne
authors.initials: SA
authors.lastname: Nah
authors.affiliation: Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore.
authors.forename: York Tien
authors.initials: YT
authors.lastname: Lee
authors.affiliation: Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore.
authors.forename: Yea-Chyi
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore.
authors.forename: Li Wei
authors.initials: LW
authors.lastname: Chiang
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D000069636:Pedestrians; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology*
keywords: child; injury; paediatric; pedestrian; trauma