Association between Time of Injury and Injury Severity after Pediatric Pedestrian Injury

ABSTRACT

PURPOSE: Pedestrian injury is one of the most frequent injury mechanism in pediatrics. This study aimed to measure the association between time of pedestrian injury and injury severity among pediatric patients. METHODS: We used the Emergency Department based Injury In-depth Surveillance (EDIIS) database from 23 emergency departments between 2013 and 2016. All pediatric (≤15 years old) patients with pedestrian injury were eligible, excluding cases with unknown outcomes. Primary and secondary endpoints was severe injury. We calculated adjusted odds ratios (AORs) of time of injury (8 am to 2 pm, 2 pm to 8 pm, 8 pm to 8 am) to investigate out-comes while adjusting for potential confounders. RESULTS: Among 6,748 eligible patients, 4,184 (62.0%) suffered pedestrian injury at 2 pm to 8 pm, 1,566 (23.2%) at 8 am to 2 pm, and 998 (14.8%) at 8 pm to 8 am. Among them, 52 (0.8%) had case-fatalities, 572 (8.5%) had severe injuries, and 1,246 (18.5%) were admitted to hospital. In terms of severe injury, the 8 am to 2 pm group (10.5%) had higher proportions of severe injury compared to the 2 pm to 8 pm (8.0%; AOR {95% confidence interval [CI]}, 0.73 [0.60 to 0.89]) and 8 pm to 8 am (7.2%; AOR [95% CI], 0.65 [0.49 to 0.88]) groups. CONCLUSION: Pediatric pedestrian injury was frequent at 2 pm to 8 pm and was more severe at 8 am to 2 pm. Public health efforts to decrease pediatric pedestrian injury are needed to reduce health burden.