Medline ® Abstracts for References 3-7
of 'Promoting safety in children with disabilities'
Injuries among disabled children: a study from Greece.
Petridou E, Kedikoglou S, Andrie E, Farmakakis T, Tsiga A, Angelopoulos M, Dessypris N, Trichopoulos D
Inj Prev. 2003;9(3):226.
OBJECTIVE: To compare the differential implications of sociodemographic and situational factors on the risk of injury among disabled and non-disabled children.
DESIGN: Data from the Emergency Department Injury Surveillance System (EDISS) were used to compare, in a quasi case-control approach, injured children with or without disability with respect to sociodemographic, event and injury variables, and to estimate adjusted odds ratios for the injury in a disabled rather than a non-disabled child.
SETTING: Two teaching hospitals in Athens and two district hospitals in the countryside that participate in the EDISS.
PATIENTS: In the five year period 1996-2000, 110 066 children were recorded with injuries; 251 among them were identified as having a motor/psychomotor or sensory disability before the injury event.
MAIN OUTCOME MEASURES: Mechanism of injury, type of injury, risk-predisposing socioeconomic and environmental variables, odds ratio for injury occurrence.
RESULTS: Falls and brain concussion are proportionally more common among disabled children, whereas upper limb and overexertion injuries are less common among them. Urban environment, migrant status, and cold months are also associated with increased odds for injuries to occur among disabled rather than non-disabled children. The odds ratio for the occurrence of an injury among disabled children increases with increasing age.
CONCLUSIONS: The results of the study provide the information for the targeting of trials of preventive measure in disabled children at increased risk of severe injuries.
Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece. email@example.com
Burn injury in patients with early-onset neurological impairments: 2002 ABA paper.
Alden NE, Rabbitts A, Rolls JA, Bessey PQ, Yurt RW
J Burn Care Rehabil. 2004;25(1):107.
Many patients suffer from sensorimotor deficits that may contribute to burn injury. This retrospective study examines burn injuries in the subgroup of patients that suffer from the early onset neurological impairments of mental retardation, cerebral palsy, spina bifida, autism, and attention deficit-hyperactivity disorder. Fifty-one patients who suffered from the above-mentioned early-onset neurological impairments were admitted to our burn center during a 4-year period. The average TBSA burned was 8.9% yet resulted in prolonged hospitalizations. This study describes our burn center's experience in treating patients admitted with early-onset neurological impairments.
New York Presbyterian Hospital-New York Weill Cornell Center, New York, New York 10021, USA.
Injuries to children who had preinjury cognitive impairment: a 10-year retrospective review.
Braden K, Swanson S, Di Scala C
Arch Pediatr Adolesc Med. 2003;157(4):336.
OBJECTIVE: To determine differences between hospitalized injured children who had preinjury cognitive impairments (IMPs) and children who had no preinjury cognitive conditions (NO).
DESIGN: Comparative analysis, excluding fatalities, of patients with IMP (n = 371) with patients with NO (n = 58 745), aged from 0 to 19 years.
MAIN OUTCOME MEASURES: Demographics, injury characteristics, injury nature and severity, use of resources, disability, and disposition at discharge from acute care.
DATA SOURCE: Medical records of children injured between January 1, 1989, and December 31, 1998, submitted to the National Pediatric Trauma Registry, Boston, Mass.
RESULTS: Compared with children with NO, children with IMPs were more likely to be boys (72.5% vs 64.3%), to be older (53.1% vs 40.0%, aged 10-19 years), to be victims of child abuse (5.9% vs 1.6%), andto be individuals with self-inflicted injuries (2.2% vs 0.1%). They were more likely to be injured as pedestrians (19.9% vs 13.8%), less likely to be injured in sport activities (2.7% vs 6.9%), and less likely to sustain a penetrating injury (3.8% vs 8.3%). They were more likely to sustain injuries to multiple body regions (57.4% vs 43.7%) and the head (62.0% vs 45.1%), and to be severely injured. They were more likely to be admitted to the intensive care unit (52.6% vs 25.2), and their mean length of stay was twice as long (9.9 vs 4.8 days). They were also more likely to develop impairments from the current injury (46.6% vs 41.0%) and more likely to be discharged to a rehabilitation facility (11.1% vs 2.3%). The IMPs became worse in 75 children.
CONCLUSIONS: Preinjury cognitive impairments in a pediatric population had a significant effect on the causes, nature, severity of injury, and outcomes. Targeted prevention programs should consider the characteristics of this population.
Department of Pediatrics, University of Massachusetts Medical School, Worcester, USA. Kathleen.Braden@umassmed.edu
Injuries to the head among children enrolled in special education.
Limbos MA, Ramirez M, Park LS, Peek-Asa C, Kraus JF
Arch Pediatr Adolesc Med. 2004;158(11):1057.
BACKGROUND: Injuries to the head comprise 20% to 39% of all school-related injuries. Head injuries among special education students have not been adequately described.
OBJECTIVES: (1) To examine the incidence and characteristics of head injuries in children enrolled in special education and (2) to determine the factors that increase the risk of sustaining a head injury compared with an injury to another part of the body.
METHODS: Pupil Accident Reports for 6769 students enrolled in 17 of 18 special education schools in 1 large urban school district during the academic years 1994-1998 were reviewed, and information on the nature of injury, external cause, and activity was abstracted. Head-injured and nonhead-injured cases were identified and compared by race, sex, age, characteristics of injury, and disability category.
RESULTS: Six hundred ninety-seven injury events were reported during the 4-year study period. The overall injury rate was 4.7 injuries per 100 student-years. Two hundred five children (29.4%) sustained injuries to the head, and the rate of head injury was 1.3 injuries per 100 student-years. Falls were the leading cause of injury. Head injuries were most commonly associated with physical education and unstructured play and usually occurred on the playground. Disproportionately more head than nonhead injuries were sustained in the classroom (12% vs 8%) and the bathroom (9% vs 3%). Compared with children with emotional/mental disabilities, children with multiple disabilities had the highest risk of a head injury (incidence density ratio, 2.4 [95% confidence interval, 1.6-3.5]), followed by children with physical disabilities (incidence density ratio, 1.8 [95% confidence interval, 1.1-3.1]). There appeared to be no significant difference in the rate of head injury by sex and age.
CONCLUSIONS: Modifications of the classroom, bathroom, and playground environments might reduce the risk of head injuries in children enrolled in special education. Special modifications and increased supervision may, in particular, reduce the risk of head injury for children with physical and multiple disabilities.
Division of General Pediatrics, Childrens Hospital Los Angeles, Los Angeles, Calif, USA. firstname.lastname@example.org
Increased risk of injury in children with developmental disabilities.
Lee LC, Harrington RA, Chang JJ, Connors SL
Res Dev Disabil. 2008 May-Jun;29(3):247-55.
The objective of this study was to examine injury risk in children with autism, ADD/ADHD, learning disability, psychopathology, or other medical conditions. Children aged 3-5 years who participated in the National Survey of Children's Health were included. Six study groups were analyzed in this report: autism (n=82), ADD/ADHD (n=191), learning disability (n=307), psychopathology (n=210), other medical conditions (n=1802), and unaffected controls (n=13,398). The weighted prevalence of injury in each group was 24.2% (autism), 26.5% (ADD/ADHD), 9.3% (learning disability), 20.5% (psychopathology), 14.6% (other medical conditions), and 11.9% (unaffected controls). Compared to unaffected controls, the risk of injury was 2.15 (95% confidence interval (CI): 1.00-4.60), 2.74 (95% CI: 1.63-4.59), 2.06 (95% CI: 1.24-3.42), and 1.26 (95% CI: 1.00-1.58) in children with autism, ADD/ADHD, psychopathology, and other medical conditions, respectively, after adjusting for child sex, child age, number of children in the household, child race, and family poverty level. Children with autism, ADD/ADHD, and other psychopathology were about 2-3 times more likely to experience an injury that needs medical attention than unaffected controls. Future studies need to clarify the extent to which injuries in young children with autism, ADD/ADHD, and psychopathology are related to core symptoms, comorbid conditions, associated behaviors, or unintentional injuries due to lack of additional supervision from caregivers.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, John Hopkins University, Baltimore, MD 21205, USA. email@example.com