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Characteristics of pediatric traumatic amputations treated in hospital emergency departments: United States, 1990-2002.
Pediatrics. 2005 Nov; 116(5):e667-74.Ped

Abstract

OBJECTIVE

To examine the characteristics of children with traumatic amputations and the products associated with these injuries.

METHODS

Data regarding amputation injuries to children younger than 18 years treated in US emergency departments from 1990 to 2002 were obtained from the National Electronic Injury Surveillance System. Data included demographics, product involved, and body region injured.

RESULTS

An estimated 111,600 children younger than 18 years with amputation injuries were treated in US emergency departments from 1990 to 2002. The average age was 6.18 years (median: 4 years; mode: 1 year old). Males experienced 65.5% of these injuries. Finger amputations accounted for 91.6% of all amputations, ranging from 95.2% among 0- to 2-year-olds to 87.9% among 13- to 17-year-olds. Complete amputations accounted for 70.2% of all amputations among 13- to 17-year-olds compared with 52.6% of amputations among 0- to 2-year-olds. Adolescents also had the highest proportion of amputations resulting in hospital admission (26.6% for 13- to 17-year-olds compared with 11.9% for 0- to 2-year-olds). Adolescents had the highest proportion of amputation injuries involving lawn mowers (14.1% for 13- to 17-year-olds compared with 1.4% for 0- to 2-year-olds) and the highest proportion of amputations involving tools (29.3% for 13- to 17-year-olds compared with 2.5% for 0- to 2-year-olds). The percentage of amputations involving doors peaked in the youngest age group and decreased as age increased (65.8% of all amputations for 0- to 2-year-olds compared with 14.1% for 13- to 17-year-olds).

CONCLUSIONS

To our knowledge, this is the first study to use a nationally representative sample to broadly investigate amputation injuries among children. The majority of traumatic amputation injuries occur to young children, to males, and to fingers and the majority involve doors. Adolescents experience a higher proportion of more serious amputation injuries. Effective interventions exist but are inadequately used to prevent many of these injuries, including door stops and modifications, bicycle-chain and spoke guards, wearing closed-toe footwear while bicycling, a no-mow-in-reverse default feature on ride-on lawnmowers with the override switch located behind the mower operator, and a SawStop system on power saws. Use of these technical countermeasures and changes in relevant product standards to promote their implementation and use could lead to a decrease in pediatric traumatic amputations.

Authors+Show Affiliations

Center for Injury Research and Policy, Columbus Children's Research Institute, Children's Hospital, Columbus, Ohio, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16263981

Citation

Hostetler, Sarah Grim, et al. "Characteristics of Pediatric Traumatic Amputations Treated in Hospital Emergency Departments: United States, 1990-2002." Pediatrics, vol. 116, no. 5, 2005, pp. e667-74.
Hostetler SG, Schwartz L, Shields BJ, et al. Characteristics of pediatric traumatic amputations treated in hospital emergency departments: United States, 1990-2002. Pediatrics. 2005;116(5):e667-74.
Hostetler, S. G., Schwartz, L., Shields, B. J., Xiang, H., & Smith, G. A. (2005). Characteristics of pediatric traumatic amputations treated in hospital emergency departments: United States, 1990-2002. Pediatrics, 116(5), e667-74.
Hostetler SG, et al. Characteristics of Pediatric Traumatic Amputations Treated in Hospital Emergency Departments: United States, 1990-2002. Pediatrics. 2005;116(5):e667-74. PubMed PMID: 16263981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics of pediatric traumatic amputations treated in hospital emergency departments: United States, 1990-2002. AU - Hostetler,Sarah Grim, AU - Schwartz,Lila, AU - Shields,Brenda J, AU - Xiang,Huiyun, AU - Smith,Gary A, PY - 2005/11/3/pubmed PY - 2005/12/29/medline PY - 2005/11/3/entrez SP - e667 EP - 74 JF - Pediatrics JO - Pediatrics VL - 116 IS - 5 N2 - OBJECTIVE: To examine the characteristics of children with traumatic amputations and the products associated with these injuries. METHODS: Data regarding amputation injuries to children younger than 18 years treated in US emergency departments from 1990 to 2002 were obtained from the National Electronic Injury Surveillance System. Data included demographics, product involved, and body region injured. RESULTS: An estimated 111,600 children younger than 18 years with amputation injuries were treated in US emergency departments from 1990 to 2002. The average age was 6.18 years (median: 4 years; mode: 1 year old). Males experienced 65.5% of these injuries. Finger amputations accounted for 91.6% of all amputations, ranging from 95.2% among 0- to 2-year-olds to 87.9% among 13- to 17-year-olds. Complete amputations accounted for 70.2% of all amputations among 13- to 17-year-olds compared with 52.6% of amputations among 0- to 2-year-olds. Adolescents also had the highest proportion of amputations resulting in hospital admission (26.6% for 13- to 17-year-olds compared with 11.9% for 0- to 2-year-olds). Adolescents had the highest proportion of amputation injuries involving lawn mowers (14.1% for 13- to 17-year-olds compared with 1.4% for 0- to 2-year-olds) and the highest proportion of amputations involving tools (29.3% for 13- to 17-year-olds compared with 2.5% for 0- to 2-year-olds). The percentage of amputations involving doors peaked in the youngest age group and decreased as age increased (65.8% of all amputations for 0- to 2-year-olds compared with 14.1% for 13- to 17-year-olds). CONCLUSIONS: To our knowledge, this is the first study to use a nationally representative sample to broadly investigate amputation injuries among children. The majority of traumatic amputation injuries occur to young children, to males, and to fingers and the majority involve doors. Adolescents experience a higher proportion of more serious amputation injuries. Effective interventions exist but are inadequately used to prevent many of these injuries, including door stops and modifications, bicycle-chain and spoke guards, wearing closed-toe footwear while bicycling, a no-mow-in-reverse default feature on ride-on lawnmowers with the override switch located behind the mower operator, and a SawStop system on power saws. Use of these technical countermeasures and changes in relevant product standards to promote their implementation and use could lead to a decrease in pediatric traumatic amputations. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/16263981/Characteristics_of_pediatric_traumatic_amputations_treated_in_hospital_emergency_departments:_United_States_1990_2002_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=16263981 DB - PRIME DP - Unbound Medicine ER -