title: Increased morbidity associated with weekend paediatric road traffic injuries: 10-year analysis of trauma registry data.
abstract: BACKGROUND
  Road traffic injuries (RTIs) are a significant cause of paediatric morbidity and mortality worldwide, with a disproportionate number of these injuries occurring in low- and middle-income countries (LMICs). Adult data from LMICs suggest that weekends are particularly high-risk for RTIs, but whether children are at increased risk of RTI on weekends has not previously been investigated in any setting. This study sought to assess patterns in paediatric RTI presentations using hospital-based trauma surveillance data in Cape Town, South Africa.
  
  
  METHODS
  Data was analysed from Childsafe South Africa's prospectively collected trauma registry for injured children below 13 years of age presenting to a tertiary paediatric referral Trauma Department between 2004 and 2013.
  
  
  RESULTS
  During the 10-year study period, a total of 71,180 patients presented with traumatic injuries, of which 8,815 (12.4%) resulted from RTIs. RTI patients had a mean age of 5.2±3.6 years, and were predominantly males and pedestrians. RTIs were more common on weekends than weekdays (2.98 vs. 2.19 patients/day, p<0.001), representing a greater proportion of daily all-cause trauma (15.5% vs. 11.2%, p<0.001). Moreover, weekend RTI patients sustained more severe injuries than on weekdays, and compared to weekend all-cause trauma patients (injury score 1.66 vs. 1.46 and 1.43, both p<0.001). RTI patients were more likely to require admission to both the trauma ward (1.14 vs. 0.79 patients/day, p<0.001) and the PICU (0.10 vs. 0.07 patients/day, p<0.05) on weekends than on weekdays. Weekend RTI patients most frequently required admission to the trauma ward (p<0.001) and the PICU (p<0.05) during the last annual quarter.
  
  
  CONCLUSIONS
  In a LMIC-setting, paediatric RTI patients are more frequently brought to medical attention, sustain more severe injuries and more frequently require hospital admission during the weekend. Weekends during the last annual quarter were particularly high-risk for paediatric RTIs. These findings highlight the importance of trauma surveillance data to inform targeted community prevention strategies for improving child road safety.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, The Montreal Children's Hospital of the McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Brett
authors.initials: B
authors.lastname: Burstein
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, The Montreal Children's Hospital of the McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Fauteux-Lamarre
authors.affiliation: Department of Pediatric Surgery, Red Cross War Memorial Children's Hospital, Rondebosch, Cape Town, South Africa. Electronic address: sebastian.vanas@uct.ac.za.
authors.forename: Arjan Bastiaan van
authors.initials: AB
authors.lastname: As
mesh_terms: D000056:Accident Prevention; D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004779:Environment Design; D005260:Female; D006801:Humans; D008297:Male; D011159:Population Surveillance; D012042:Registries; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D014193:Trauma Centers / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000517:prevention & control
keywords: Motor vehicle crash; Road traffic crash; Surveillance; Weekday versus weekend