Children and adolescents deaths from trauma-related causes in a Brazilian City

World Journal of Emergency Surgery

Raul Coimbra⁵  Emilio Carlos Elias Baracat¹  Marcelo Conrado Reis⁴  Gustavo Pereira Fraga²  Thais Marconi Fernandez⁶  Joaquim Murray Bustorff-Silva³  Andrea Melo Alexandre Fraga⁴ 

[1] Pediatric Emergency Division, Department of Pediatrician, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP, Brazil;Division of Trauma Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP, Brazil;Division of Pediatric Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP, Brazil;Pediatric Emergency Division, Hospital de Clinicas, University of Campinas, Campinas, SP, Brazil;The Monroe E. Trout Professor of Surgery, Department of Surgery, Division of Trauma, Surgical Critical Care, and Burns, University of California San Diego, 200 West Arbor Dr, #8896, San Diego, CA 92103-8896, USA;School of Medical Sciences, University of Campinas (Unicamp), Rua Alexander Fleming, 181, Cidade Universitária “Prof. Zeferino Vaz”, Barão Geraldo, Campinas, SP, Brazil

关键词: Brain injuries;    Drowning;    Multiple trauma;    Gunshot;    Wounds;   

Others  :  791567
DOI  :  10.1186/1749-7922-8-52

 received in 2013-09-02, accepted in 2013-11-25,  发布年份 2013

【 摘 要 】

Introduction

Injury is the first cause of death worldwide in the population aged 1 to 44. In developed countries, the most common trauma-related injuries resulting in death during childhood are traffic accidents, followed by drowning.

Methods

This retrospective study based on autopsy examinations describes the epidemiology profile of deaths by trauma-related causes in individuals younger than 18 years from 2001 to 2008 in the city of Campinas. The aim is to identify epidemiology changes throughout the years in order to develop strategies of prevention.

Results

There were 2,170 deaths from all causes in children < 18 years old, 530 of which were due to trauma-related causes, with a male predominance of 3.4:1. The age distribution revealed that 76% of deaths occurred in the 10-17 age group. The most predominant trauma cause was firearm injury (47%). Other frequent causes were transport-related injuries (138 cases-26%; pedestrians were struck in 57.2% of these cases) and drowning (55 cases-10.4%). Asphyxia/suffocation was the cause of death in 72% of cases in children < 1 year old; drowning (30.8%) was predominant in the 1-4 age group; transport-related deaths were frequent in the 5-9 age group (56%) and the 10-14 age group (40.4%). Gun-related deaths were predominant (68%) in the 14-17 age group. 51% of deaths occurred at the scene.

Conclusions

There was a predominance of deaths in children and adolescents males, between 15-17 years old, mainly from gun-related homicides, and the frequency has decreased since 2004 after the disarmament statute and the combating of violence.

【 授权许可】

   
2013 Fraga et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Peden M, Oyegbite K, Ozanne-Smith J, Hyder AA, Branche C, Fazlur-Rahman AKM, Rivara F, Bartolomeos K: World report on child injury prevention. Geneva: World Health Organization; 2008.
• [2]Nagaraja J, Menkedick J, Phelan KJ, Ashley P, Zhang X, Lanphear BP: Deaths from residential injuries in US children and adolescents, 1985-1997. Pediatrics 2005, 116:454-461.
• [3]Committee on Child Abuse and Neglect; Committee on Injury, Violence, and Poison Prevention; Council on Community Pediatrics, American Academy of Pediatrics: Policy statement–child fatality review. Pediatrics 2010, 126(3):592-596.
• [4]Reichenheim ME, De Souza ER, Moraes CL, De Mello Jorge MH, da Silva CM, De Souza Minayo MC: Violence and injuries in Brazil: the effect, progress made, and challenges ahead. Lancet 2011, 377(9781):1962-1975.
• [5]Ministério da Saúde: Sistema de Informação sobre Mortalidade. Available from URL: http://www.datasus.gov.br/DATASUS webcite Accessed August 30th, 2013
• [6]Barros MD, Ximenes R, de Lima ML: Child and adolescent mortality due to external causes: trends from 1979 to 1995. Rev Saude Publica 2001, 35:142-149.
• [7]Gawryszewski VP, Rodrigues EM: The burden of injury in Brazil, 2003. Sao Paulo Med J 2006, 124:208-213.
• [8]Gawryszeski VP: Injury mortality report for São Paulo State, 2003. Sao Paulo Med J 2007, 125:139-143.
• [9]Hjern A, Bremberg S: Social aetiology of violent deaths in Swedish children and youth. J Epidemiol Community Health 2002, 56(9):688-692.
• [10]Pan SY, Ugnat AM, Semenciw R, Desmeules M, Mao Y, Macleod M: Trends in childhood injury mortality in Canada, 1979-2002. Inj Prev 2006, 12(3):155-160.
• [11]Fraga AM, Fraga GP, Stanley C, Costantini TW, Coimbra R: Children at danger: injury fatalities among children in San Diego County. Eur J Epidemiol 2010, 25(3):211-217.
• [12]Kanchan T, Menezes RG: Mortalities among children and adolescents in Manipal, Southern India. J Trauma 2008, 64(6):1600-1607.
• [13]Jiang G, Choi BC, Wang D, Zhang H, Zheng W, Wu T, Chang G: Leading causes of death from injury and poisoning by age, sex and urban/rural areas in Tianjin, China 1999-2006. Injury 2011, 42(5):501-506.
• [14]Bener A, Hussain SJ, Ghaffar A, Abou-Taleb H, El-Sayed HF: Trends in childhood trauma mortality in the fast economically developing State of Qatar. World J Pediatr 2011, 7(1):41-44.
• [15]Ruiz-Casares M: Unintentional childhood injuries in sub-Saharan Africa: an overview of risk and protective factors. J Health Care Poor Underserved 2009, 20(4 Suppl):51-67.
• [16]Brehaut JC, Miller A, Raina P: Childhood behavior disorders and injuries among children and youth: a population based study. Pediatrics 2003, 111:262-269.
• [17]Jagnoor J, Bassani DG, Keay L, Ivers RQ, Thakur JS, Gururaj G, Jha P: Million death study collaborators: unintentional injury deaths among children younger than 5 years of age in India: a nationally representative study. Inj Prev 2011, 17(3):151-155.
• [18]Agran PF, Winn D, Anderson C, Trent R, Walton-Haynes L: Rates of pediatric and adolescent injuries by year of age. Pediatrics 2001, 108(3):E45.
• [19]Hijar M, Chu LD, Kraus JF: Cross-national comparison of injury mortality: Los Angeles County, California and Mexico City, Mexico. Int J Epidemiol 2000, 29(4):715-721.
• [20]Galduróz JC, Caetano R: Epidemiology of alcohol use in Brazil. Rev Bras Psiquiatr 2004, 26(Suppl 1):S3-S6.
• [21]Posada J, Ben-Michael E, Herman A, Kahan E, Richter E: Death and injury from motor vehicle crashes in Colombia. Rev Panam Salud Publica 2000, 7(2):88-91.
• [22]Carrasco CE, Godinho M, De Azevedo Barros MB, Rizoli S, Fraga GP: Fatal motorcycle crashes: a serious public health problem in Brazil. World J Emerg Surg 2012, 7(Suppl 1):S5.
• [23]Lin MR, Chang SH, Huang W, Hwang HF, Pai L: Factors associated with severity of motorcycle injuries among young adult riders. Ann Emerg Med 2003, 41(6):783-791.
• [24]Masella CA, Pinho VF, Costa Passos AD, Spencer Netto FA, Rizoli S, Scarpelini S: Temporal distribution of trauma deaths: quality of trauma care in a developing country. J Trauma 2008, 65(3):653-658.
• [25]Demetriades D, Murray J, Charalambides K, Alo K, Velmahos G, Rhee P, Chan L: Trauma fatalities: time and location of hospital deaths. J Am Col Surg 2004, 198(1):20-26.
• [26]Cothren CC, Moore EE, Hedegaard HB, Meng K: Epidemiology of urban trauma deaths: a comprehensive reassessment 10 years later. World J Surg 2007, 31(7):1507-1511.
• [27]Roaten JB, Partrick DA, Nydam TL, Bensard DD, Hendrickson RJ, Sirotnak AP, Karrer FM: Nonaccidental trauma is a major cause of morbidity and mortality among patients at a regional level 1 pediatric trauma center. J Pediatr Surg 2006, 41(12):2013-2015.
• [28]Sharma G, Shrestha PK, Wasti H, Kadel T, Ghimire P, Dhungana S: A review of violent and traumatic deaths in Kathmandu, Nepal. Int J Inj Contr Saf Promot 2006, 13(3):197-199.
• [29]Meel BL: Mortality of children in the Transkei region of South Africa. Am J Forensic Med Pathol 2003, 24(2):141-147.
• [30]Fujiwara T, Barber C, Schaechter J, Hemenway D: Characteristics of infant homicides: findings from a U.S. multisite reporting system. Pediatrics 2009, 124(2):e210-e217.
• [31]Scholer SJ, Hickson GB, Ray WA: Sociodemographic factors identify US infants at high risk of injury mortality. Pediatrics 1999, 103(6 Pt 1):1183-1188.
• [32]Hoppe-Roberts JM, Lloyd LM, Chyka PA: Poisoning mortality in the United States: comparison of national mortality statistics and poison control center reports. Ann Emerg Med 2000, 35(5):440-448.
• [33]Rimsza ME, Schackner RA, Bowen KA, Marshall W: Can child deaths be prevented? The Arizona child fatality review program experience. Pediatrics 2002, 110(1 Pt 1):e11.
• [34]Gielen AC, McDonald EM, Wilson ME, Hwang WT, Serwint JR, Andrews JS, Wang MC: Effects of improved access to safety counseling, products, and home visits on parents’ safety practices: results of a randomized trial. Arch Pediatr Adolesc Med 2002, 156(1):33-40.
• [35]Baracat EC, Paraschin K, Nogueira RJ, Reis MC, Fraga AM, Sperotto G: Accidents with children in the region of Campinas, Brazil. J Pediatr (Rio J) 2000, 76(5):368-374.