Pediatric Injury Epidemiology: National Evidence and the Case for Regional Analyses in Hampton Roads
Poster #: 029
Session/Time: B
Author:
Alexander Dornstauder, MS
Mentor:
Kean Feyzeau, MD
Research Type: Review Article
Abstract
INTRODUCTION:
Children's health outcomes in the United States have worsened, and injury remains a leading cause of pediatric emergency department (ED) visits, hospitalization, and death. Falls, motor vehicle collisions, sports-related trauma, and firearm incidents affect children differently depending on age, sex, race, and care setting. National datasets provide valuable epidemiologic data but lack pediatric-specific detail and regional granularity. Hampton Roads, Virginia, is a diverse region with both pediatric and general EDs, yet little has been published on its local pediatric injury burden. Without such data, prevention strategies, hospital preparedness, and resource allocation remain constrained.
MAIN BODY:
The literature shows that most pediatric injuries are preventable, though mechanisms evolve with age and context. Over the past decade, firearm-related injuries have risen sharply, surpassing motor vehicle collisions as the leading cause of injury-related death among U.S. children and adolescents. Firearm injuries have increased while blunt-force and pedestrian injuries have declined. Motor vehicle crashes remain a major source of severe trauma but have plateaued in fatal cases, even as overall trauma-related ED visits have grown. Falls continue to be common, especially among younger children, with more trampoline and playground injuries. The COVID-19 pandemic further shifted patterns, with decreased overall trauma volume but greater injury severity and higher rates of penetrating trauma. Disparities in injury outcomes are well documented. White adolescents sustain higher rates of sports- and vehicle-related head trauma, while Black adolescents more often experience assault and weapon-related trauma. Self-inflicted harm is rising in younger girls, while assault remains common in older boys. Black, Hispanic, Pacific Islander, and rural children bear disproportionate burdens of severe trauma and worse outcomes. Regionally specific analyses reveal substantial variability shaped by demographics and urban-rural differences. Some trauma centers reported >100% increases in penetrating injuries during the COVID-19 pandemic, while others saw declines. Urban centers more often report firearm and intentional trauma among socioeconomically disadvantaged children, whereas rural regions experience higher rates of motor vehicle trauma with limited access to specialized care.
CONCLUSION:
This literature review highlights national trends and disparities, as well as regional variability in pediatric injuries. Large, multicenter cohort studies have shown that working towards improved readiness is independently associated with lower in-hospital mortality, even after adjustment. However, geospatial analyses link regional disparities in outcomes to variability in ED readiness and survival, particularly in rural and underserved areas, likely due to lack of regional data. It is unclear based on this review alone which specific injuries Hampton Roads hospitals need to be most prepared. National-level datasets do not fully capture the specific epidemiology of regions like Hampton Roads with enough detail to assess local trends. This review suggests the need for further study using local database resources to provide granular data to guide trauma system planning and support community-level prevention strategies. By bridging the gap between national evidence and local context, this work can provide the data needed to reduce preventable injury and inform local practice.
Children's health outcomes in the United States have worsened, and injury remains a leading cause of pediatric emergency department (ED) visits, hospitalization, and death. Falls, motor vehicle collisions, sports-related trauma, and firearm incidents affect children differently depending on age, sex, race, and care setting. National datasets provide valuable epidemiologic data but lack pediatric-specific detail and regional granularity. Hampton Roads, Virginia, is a diverse region with both pediatric and general EDs, yet little has been published on its local pediatric injury burden. Without such data, prevention strategies, hospital preparedness, and resource allocation remain constrained.
MAIN BODY:
The literature shows that most pediatric injuries are preventable, though mechanisms evolve with age and context. Over the past decade, firearm-related injuries have risen sharply, surpassing motor vehicle collisions as the leading cause of injury-related death among U.S. children and adolescents. Firearm injuries have increased while blunt-force and pedestrian injuries have declined. Motor vehicle crashes remain a major source of severe trauma but have plateaued in fatal cases, even as overall trauma-related ED visits have grown. Falls continue to be common, especially among younger children, with more trampoline and playground injuries. The COVID-19 pandemic further shifted patterns, with decreased overall trauma volume but greater injury severity and higher rates of penetrating trauma. Disparities in injury outcomes are well documented. White adolescents sustain higher rates of sports- and vehicle-related head trauma, while Black adolescents more often experience assault and weapon-related trauma. Self-inflicted harm is rising in younger girls, while assault remains common in older boys. Black, Hispanic, Pacific Islander, and rural children bear disproportionate burdens of severe trauma and worse outcomes. Regionally specific analyses reveal substantial variability shaped by demographics and urban-rural differences. Some trauma centers reported >100% increases in penetrating injuries during the COVID-19 pandemic, while others saw declines. Urban centers more often report firearm and intentional trauma among socioeconomically disadvantaged children, whereas rural regions experience higher rates of motor vehicle trauma with limited access to specialized care.
CONCLUSION:
This literature review highlights national trends and disparities, as well as regional variability in pediatric injuries. Large, multicenter cohort studies have shown that working towards improved readiness is independently associated with lower in-hospital mortality, even after adjustment. However, geospatial analyses link regional disparities in outcomes to variability in ED readiness and survival, particularly in rural and underserved areas, likely due to lack of regional data. It is unclear based on this review alone which specific injuries Hampton Roads hospitals need to be most prepared. National-level datasets do not fully capture the specific epidemiology of regions like Hampton Roads with enough detail to assess local trends. This review suggests the need for further study using local database resources to provide granular data to guide trauma system planning and support community-level prevention strategies. By bridging the gap between national evidence and local context, this work can provide the data needed to reduce preventable injury and inform local practice.