Pediatric Trauma Mortality Differs by Neighborhood Opportunity Level
Traumatic injuries are a leading cause of death in children and a child's neighborhood characteristics can be a risk factor. Our objective was to describe the association between pediatric trauma mortality and Child Opportunity Index (COI). A multicenter, retrospective cross-sectional study was...
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| Veröffentlicht in: | Journal of pediatric surgery 2024-09, p.161950, Article 161950 |
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| creator | O'Guinn, MaKayla L. Ginther, Anna Ourshalimian, Shadassa Spurrier, Ryan G. Chaudhari, Pradip P. |
| description | Traumatic injuries are a leading cause of death in children and a child's neighborhood characteristics can be a risk factor. Our objective was to describe the association between pediatric trauma mortality and Child Opportunity Index (COI).
A multicenter, retrospective cross-sectional study was conducted across 15 trauma centers from 2010 to 2021 within a large metropolitan county to evaluate trauma activation mortalities involving children |
| doi_str_mv | 10.1016/j.jpedsurg.2024.161950 |
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A multicenter, retrospective cross-sectional study was conducted across 15 trauma centers from 2010 to 2021 within a large metropolitan county to evaluate trauma activation mortalities involving children <18 years-old. We examined clinical and demographic data from the county trauma registry and linked home zip code to COI, a measure of neighborhood level resources critical for children's development. Proportion of mortalities were compared to the proportion of children within each COI quintile and injury mechanism was evaluated across COI quintile. Analysis was performed using Kruskal–Wallis and chi-square tests (α = 0.05).
Of 31,702 pediatric trauma activations, 513 (1.6%) mortalities occurred. Mortalities mostly resulted from assaults (37.0%), pedestrian injuries (26.7%), and motor-vehicle collisions (18.7%). Of all mortalities, 32.6% were firearm related, either from an assault or self-inflicted. A greater proportion of mortalities were children from very low (47.6%) and low (20.9%) COI neighborhoods with fewer from higher (8.8.% and 7.6%) COI-neighborhoods compared to the county's proportion of children within these quintiles (p < 0.001). The injury mechanisms were different, with mortalities of lower COI neighborhoods being associated with assaults (p = 0.005), while mortalities of higher COI neighborhoods were self-inflicted (p = 0.003).
Lower opportunity neighborhoods had a higher incidence of pediatric trauma mortality. Mortality mechanism varied across neighborhoods with assault greater in lower opportunity neighborhoods and self-inflicted among higher opportunity neighborhoods.
Level III.
What is currently known about this topic?•Neighborhood-level factors have been associated with disparities in pediatric trauma outcomes.
What new information is contained in this article?•Pediatric trauma mortality is disproportionate across neighborhood opportunity levels and is associated with differences in injury mechanism and firearm involvement amongst fatal pediatric trauma activations in LA County.</description><identifier>ISSN: 0022-3468</identifier><identifier>ISSN: 1531-5037</identifier><identifier>EISSN: 1531-5037</identifier><identifier>DOI: 10.1016/j.jpedsurg.2024.161950</identifier><identifier>PMID: 39358081</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Child opportunity index ; Community ; Death ; Fatality ; Mortality ; Neighborhoods ; Pediatric trauma</subject><ispartof>Journal of pediatric surgery, 2024-09, p.161950, Article 161950</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1601-2fce839795ee4f12384007ddf870e3fe27d4353495439b70c8afb52c9d7f8a083</cites><orcidid>0000-0003-0865-0262 ; 0000-0002-7732-632X ; 0000-0002-5635-9958</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpedsurg.2024.161950$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39358081$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Guinn, MaKayla L.</creatorcontrib><creatorcontrib>Ginther, Anna</creatorcontrib><creatorcontrib>Ourshalimian, Shadassa</creatorcontrib><creatorcontrib>Spurrier, Ryan G.</creatorcontrib><creatorcontrib>Chaudhari, Pradip P.</creatorcontrib><title>Pediatric Trauma Mortality Differs by Neighborhood Opportunity Level</title><title>Journal of pediatric surgery</title><addtitle>J Pediatr Surg</addtitle><description>Traumatic injuries are a leading cause of death in children and a child's neighborhood characteristics can be a risk factor. Our objective was to describe the association between pediatric trauma mortality and Child Opportunity Index (COI).
A multicenter, retrospective cross-sectional study was conducted across 15 trauma centers from 2010 to 2021 within a large metropolitan county to evaluate trauma activation mortalities involving children <18 years-old. We examined clinical and demographic data from the county trauma registry and linked home zip code to COI, a measure of neighborhood level resources critical for children's development. Proportion of mortalities were compared to the proportion of children within each COI quintile and injury mechanism was evaluated across COI quintile. Analysis was performed using Kruskal–Wallis and chi-square tests (α = 0.05).
Of 31,702 pediatric trauma activations, 513 (1.6%) mortalities occurred. Mortalities mostly resulted from assaults (37.0%), pedestrian injuries (26.7%), and motor-vehicle collisions (18.7%). Of all mortalities, 32.6% were firearm related, either from an assault or self-inflicted. A greater proportion of mortalities were children from very low (47.6%) and low (20.9%) COI neighborhoods with fewer from higher (8.8.% and 7.6%) COI-neighborhoods compared to the county's proportion of children within these quintiles (p < 0.001). The injury mechanisms were different, with mortalities of lower COI neighborhoods being associated with assaults (p = 0.005), while mortalities of higher COI neighborhoods were self-inflicted (p = 0.003).
Lower opportunity neighborhoods had a higher incidence of pediatric trauma mortality. Mortality mechanism varied across neighborhoods with assault greater in lower opportunity neighborhoods and self-inflicted among higher opportunity neighborhoods.
Level III.
What is currently known about this topic?•Neighborhood-level factors have been associated with disparities in pediatric trauma outcomes.
What new information is contained in this article?•Pediatric trauma mortality is disproportionate across neighborhood opportunity levels and is associated with differences in injury mechanism and firearm involvement amongst fatal pediatric trauma activations in LA County.</description><subject>Child opportunity index</subject><subject>Community</subject><subject>Death</subject><subject>Fatality</subject><subject>Mortality</subject><subject>Neighborhoods</subject><subject>Pediatric trauma</subject><issn>0022-3468</issn><issn>1531-5037</issn><issn>1531-5037</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkMtOwzAQRS0EouXxCyhLNiljO06cHag8pUJZlLXl2OPiKm2CnSD170nVwpbVSKNz52oOIVcUJhRofrOarFq0sQ_LCQOWTWhOSwFHZEwFp6kAXhyTMQBjKc9yOSJnMa4AhjXQUzLiJRcSJB2T-3e0XnfBm2QRdL_WyWsTOl37bpvce-cwxKTaJm_ol59VEz6bxibzth2YfrNjZviN9QU5cbqOeHmY5-Tj8WExfU5n86eX6d0sNTQHmjJnUPKyKAVi5ijjMgMorHWyAOQOWWEzLnhWioyXVQFGalcJZkpbOKlB8nNyvb_bhuarx9iptY8G61pvsOmj4pQywUqgMKD5HjWhiTGgU23wax22ioLaGVQr9WtQ7QyqvcEheHXo6Ks12r_Yr7IBuN0DOHz67TGoaDxuzOAxoOmUbfx_HT9hIYTM</recordid><startdate>20240921</startdate><enddate>20240921</enddate><creator>O'Guinn, MaKayla L.</creator><creator>Ginther, Anna</creator><creator>Ourshalimian, Shadassa</creator><creator>Spurrier, Ryan G.</creator><creator>Chaudhari, Pradip P.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0865-0262</orcidid><orcidid>https://orcid.org/0000-0002-7732-632X</orcidid><orcidid>https://orcid.org/0000-0002-5635-9958</orcidid></search><sort><creationdate>20240921</creationdate><title>Pediatric Trauma Mortality Differs by Neighborhood Opportunity Level</title><author>O'Guinn, MaKayla L. ; Ginther, Anna ; Ourshalimian, Shadassa ; Spurrier, Ryan G. ; Chaudhari, Pradip P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1601-2fce839795ee4f12384007ddf870e3fe27d4353495439b70c8afb52c9d7f8a083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Child opportunity index</topic><topic>Community</topic><topic>Death</topic><topic>Fatality</topic><topic>Mortality</topic><topic>Neighborhoods</topic><topic>Pediatric trauma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Guinn, MaKayla L.</creatorcontrib><creatorcontrib>Ginther, Anna</creatorcontrib><creatorcontrib>Ourshalimian, Shadassa</creatorcontrib><creatorcontrib>Spurrier, Ryan G.</creatorcontrib><creatorcontrib>Chaudhari, Pradip P.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Guinn, MaKayla L.</au><au>Ginther, Anna</au><au>Ourshalimian, Shadassa</au><au>Spurrier, Ryan G.</au><au>Chaudhari, Pradip P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pediatric Trauma Mortality Differs by Neighborhood Opportunity Level</atitle><jtitle>Journal of pediatric surgery</jtitle><addtitle>J Pediatr Surg</addtitle><date>2024-09-21</date><risdate>2024</risdate><spage>161950</spage><pages>161950-</pages><artnum>161950</artnum><issn>0022-3468</issn><issn>1531-5037</issn><eissn>1531-5037</eissn><abstract>Traumatic injuries are a leading cause of death in children and a child's neighborhood characteristics can be a risk factor. Our objective was to describe the association between pediatric trauma mortality and Child Opportunity Index (COI).
A multicenter, retrospective cross-sectional study was conducted across 15 trauma centers from 2010 to 2021 within a large metropolitan county to evaluate trauma activation mortalities involving children <18 years-old. We examined clinical and demographic data from the county trauma registry and linked home zip code to COI, a measure of neighborhood level resources critical for children's development. Proportion of mortalities were compared to the proportion of children within each COI quintile and injury mechanism was evaluated across COI quintile. Analysis was performed using Kruskal–Wallis and chi-square tests (α = 0.05).
Of 31,702 pediatric trauma activations, 513 (1.6%) mortalities occurred. Mortalities mostly resulted from assaults (37.0%), pedestrian injuries (26.7%), and motor-vehicle collisions (18.7%). Of all mortalities, 32.6% were firearm related, either from an assault or self-inflicted. A greater proportion of mortalities were children from very low (47.6%) and low (20.9%) COI neighborhoods with fewer from higher (8.8.% and 7.6%) COI-neighborhoods compared to the county's proportion of children within these quintiles (p < 0.001). The injury mechanisms were different, with mortalities of lower COI neighborhoods being associated with assaults (p = 0.005), while mortalities of higher COI neighborhoods were self-inflicted (p = 0.003).
Lower opportunity neighborhoods had a higher incidence of pediatric trauma mortality. Mortality mechanism varied across neighborhoods with assault greater in lower opportunity neighborhoods and self-inflicted among higher opportunity neighborhoods.
Level III.
What is currently known about this topic?•Neighborhood-level factors have been associated with disparities in pediatric trauma outcomes.
What new information is contained in this article?•Pediatric trauma mortality is disproportionate across neighborhood opportunity levels and is associated with differences in injury mechanism and firearm involvement amongst fatal pediatric trauma activations in LA County.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39358081</pmid><doi>10.1016/j.jpedsurg.2024.161950</doi><orcidid>https://orcid.org/0000-0003-0865-0262</orcidid><orcidid>https://orcid.org/0000-0002-7732-632X</orcidid><orcidid>https://orcid.org/0000-0002-5635-9958</orcidid></addata></record> |
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| ispartof | Journal of pediatric surgery, 2024-09, p.161950, Article 161950 |
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| language | eng |
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| source | ScienceDirect Journals (5 years ago - present) |
| subjects | Child opportunity index Community Death Fatality Mortality Neighborhoods Pediatric trauma |
| title | Pediatric Trauma Mortality Differs by Neighborhood Opportunity Level |
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