Development and Use of a Childrens Injury database

Ashley Bridgmon, MPH, MBA
Jennifer E. McCain, MD
Kathy Monroe, MSQI, MD
William King, RPh, MPH, DrPH

The Children’s Injury Database (CID) was developed from emergency department (ED) visit data at our pediatric hospital. CID has 3 objectives: 1) to collect, analyze, interpret and report epidemiologic and clinical data; 2) to translate these data to community preventive action; 3) to stimulate new research and educational projects in injury prevention.

Epidemiologic, financial, clinical and outcomes variables are provided by our hospital Information Systems in Excel and data analysis is performed using Epi Info Version 7 (CDC). Report formats are developed by the core research team and includes Al Safe Kids and IFCK program leadership. CID and research projects utilizing CID data are IRB reviewed and approved.

During 2021, a total of 15,142 injury visits were analyzed representing 22% of total ED visits (68,834). A total of 2,049 injury visits (13.5%) resulted in hospital admission. Males accounted for 56.8% and racial representation included white (56.7%) black (41.1%) and other (2.2%). The median age of injury patients was 6 years. Median ESI was 4.0. T1 and T2 were documented for 2.7% of injury visits. Seasonal distribution was near uniform, although spring had the highest proportion of injury visits at 27.6%. The 10 leading injury types included (in rank order): falls, poison, mvc, atv, assault, dog bites, sports, burns, pedestrian, bicycle. The injuries with highest admission rates (%) were drowning (40.0%), motorcycle (34.4%), foreign body (35.8%), self-harm (34.8%), poisoning (32.6%), ATV (29.0%). Injury ED visits (admissions and discharges) accounted for $197,476,732 in total charges and among those admitted, 10,407 days of stay. Admission rates varied by age group with ages 13 years and older having the highest rate of admission of 18.5%. Over two years, data from CID has been used in over 23 reports supporting education planning and policy development by our hospital. Additionally, during 2021, CID contributed data to 5 research projects submitted to regional and national meetings.

ED injury surveillance (EDIS) can be a valuable tool for understanding the epidemiology of serious, nonfatal forms of child injury. CID has highlighted local area and state priority injuries for community based injury prevention programs and can support statewide policy efforts. Hospital web based messaging, blogs, podcasts and other forms can be data driven and location specific. Importantly, EDIS can be a stimulus for new research ideas, intervention planning and evaluation.

1. review the importance of local surveillance of injuries
2. demonstrate the usefulness of maintaining a local injury database
3. illustrate uses of a database (outreach planning, priorizing projects, research, etc)