title: Are falls more common than road traffic accidents in pediatric trauma? Experience from a Level 1 trauma centre in New Delhi, India.
abstract: OBJECTIVE
  The epidemiology of pediatric trauma is different in different parts of the world. Some re- searchers suggest falls as the most common mechanism, whereas others report road traffic accidents (RTAs) as the most common cause. The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi, India.
  
  
  METHODS
  Inpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry. All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included. Data were retrieved in predesigned proformas. Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21.
  
  
  RESULTS
  We had 300 patients over a 33 month period. Among them, 236 (78.6%) were males and 64 (21.3%) females. Overall the predominant cause was RTAs in 132 (43%) patients. On subgroup analysis of up to 12 years age group (n = 147), the most common cause was found to be RTAs again. However, falls showed an incremental upward trend (36.05% in up to 12 age group versus 27% overall), catching up with RTAs (44.89%). Pediatric Trauma Score (PTS) ranged from 0 to 12 with a mean of 8.12 ± 2.022. 223 (74.33%) patients experienced trauma limited to one anatomic region only, whereas 77 (25.66%) patients suffered polytrauma. 288 patients were discharged to home care. Overall, 12 patients expired in the cohort. Median hospital stay was 6 days (range 1-182).
  
  
  CONCLUSIONS
  Pediatric trauma is becoming a cause of increasing concern, especially in the developing countries. The leading cause of admissions in Trauma Surgery is RTAs (43%) as compared to falls from height (27%); however, falls from height are showing an increasing trend as we move to younger age groups. Enhancing road safety alone may not be a lasting solution for prevention of pediatric trauma and local injury patterns must be taken into account when formulating policies to address this unique challenge.
authors.affiliation: JPN Apex Trauma Centre, New Delhi 110029, India.
authors.forename: Annu
authors.initials: A
authors.lastname: Babu
authors.forename: Amulya
authors.initials: A
authors.lastname: Rattan
authors.forename: Piyush
authors.initials: P
authors.lastname: Ranjan
authors.forename: Maneesh
authors.initials: M
authors.lastname: Singhal
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.forename: Subodh
authors.initials: S
authors.lastname: Kumar
authors.forename: Biplab
authors.initials: B
authors.lastname: Mishra
authors.forename: Sushma
authors.initials: S
authors.lastname: Sagar
mesh_terms: D000058:Accidental Falls / Q000401:mortality / Q000706:statistics & numerical data*; D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003906:Developing Countries; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D010372:Pediatrics; D012042:Registries; D018570:Risk Assessment; D015996:Survival Rate; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery