Epidemiological Analysis of Paediatric Trauma in Intensive Care: A 10-Year Retrospective Study from 2009 to 2018

Epidemiological Analysis of Paediatric Trauma in Intensive Care: A 10-Year Retrospective Study from 2009 to 2018 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Epidemiological Analysis of Paediatric Trauma in Intensive Care: A 10-Year Retrospective Study from 2009 to 2018 Yiyao Bao, Jing Ye, Lei Hu, Lijun Guan, Caina Gao, Linhua Tan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4713267/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 3 You are reading this latest preprint version Abstract Background Paediatric trauma is a pivotal factor contributing to paediatric mortality, with traffic injuries and falls being commonly reported as leading causes of significant injuries among children. Comprehensive investigations from multiple perspectives, including geographical considerations, are crucial to develop more effective strategies for preventing such injuries and thereby reducing the burden of paediatric trauma. Methods This study involved a retrospective analysis of clinical data from paediatric patients admitted to our hospital's intensive care unit (ICU) due to trauma over a 10-year period. Comprehensive analyses were conducted to elucidate trends, demographics, injury patterns, and risk factors associated with these admissions. Results This retrospective study included 951 paediatric patients (mean age: 4.79 ± 3.24 years; mean weight: 18.45 ± 9.02 kg; median time to ICU admission post-injury: 10.86 ± 14.95 hours). Of these patients, 422 (44.4%) underwent emergency surgery and 466 (49%) required mechanical ventilation support, with a mean duration of 70.19 ± 146.62 hours. The mean duration of ICU stay was 6.24 ± 8.01 days and overall mean hospital stay was 16.08 ± 15.56 days. The predominant cause of unintentional injury was traffic accidents (47.9%), followed by falls (42.5%) and burns/scalds (5.3%). Most incidents involved children aged 0–6 years (70.7%), with males comprising 60.0% of cases. Injury incidents predominantly occurred between 12 PM and 6 PM (44.5%) and on non-workdays (37.6%). The most common sites of injury were roadsides (49.0%) and rural areas (64.35%). Single-site injuries (58.78%) were more prevalent than multiple-site injuries (41.22%), and head injuries were the most common among single-site injuries (81.57%). At ICU admission, the mean injury severity score was 18.49 ± 8.86. Following active intervention, 871 patients (91.59%) showed improvement, whereas 80 (8.41%) succumbed to their injuries. Conclusion Traffic injuries remain the primary cause of paediatric trauma, underscoring the ongoing importance of appropriate use of child restraint systems and protective gear as fundamental preventive measures. The elevated incidence of injuries among children under 6 years old and those residing in rural areas highlights the need for targeted preventive strategies, necessitating tailored interventions and public policy formulations that specifically address these high-risk populations. Paediatrics trauma intensive care injury patterns risk factors Background Trauma is defined as the disruption of human tissues or organs caused by mechanical forces [ 1 ]. It encompasses a broad spectrum of external bodily injuries in children, including those resulting from road traffic accidents, falls, blunt forces, cuts, sprains, burns, and abuse, typically occurring unexpectedly. It is the leading cause of unintentional injury during childhood and a pivotal cause of paediatric mortality [ 2 , 3 ]. It is reported that approximately 830,000 children die from unintentional injuries annually [ 4 ]. In the United States, approximately 22 million children, or one-third of the child population, experience such injuries annually [ 5 ]. On average, there are approximately 6,000 children (aged 0–14 years) who die from injuries annually in the European Union [ 6 ]. In China, trauma accounts for 21.26% of paediatric injuries, with a mortality rate of 28.12 per 100,000 [ 7 ]. Trauma has surpassed other diseases to become the most common cause of death or morbidity among children and adolescents [ 8 ], imposing a significant physical and psychological burden on the affected children and their families [ 9 , 10 ]. The risk factors and characteristics of paediatric trauma vary between developed and developing countries, influenced by social resources and economic conditions. Consequently, prevention and treatment strategies developed in wealthy nations may not be universally applicable to less prosperous ones. Research suggests that up to 90% of traumas can be prevented through effective interventions [ 11 ]. Trauma is influenced by multifactorial elements, including individual, familial, societal, and regional factors, and exhibits regional peculiarities with correlations with geographical and economic contexts. The causes of trauma also differ according to age, sex, and living environment [ 12 ]. Therefore, gaining a thorough understanding of the factors contributing to paediatric trauma and meticulously analysing the triggers and types of injuries are crucial for implementing more effective preventive measures, safeguarding children’s lives, and fostering a secure and harmonious environment conducive to their healthy development. The significance of this study and other information may help guide prevention strategies aimed at reducing the incidence of accidental injuries among children in the Chinese mainland. We present the following article in accordance with the STROBE reporting checklist. Methods Participants The inclusion criteria were as follows: (1) timeframe, January 1, 2009 to December 31, 2018; (2) age < 18 years; and (3) trauma resulting from falls, traffic incidents, machinery accidents, or other unintentional injuries, with the incident being the patient's first traumatic experience. The exclusion criteria were as follows: (1) intracranial injuries secondary to neurological disorders, such as spontaneous intracranial haemorrhage, brain tumours, and epilepsy; (2) pre-injury cardiac function classified as New York Heart Association Class II or higher, liver function categorised as Child-Pugh Class B or worse, or glomerular filtration rate < 90 ml/min; and (3) presence of congenital metabolic disorders. Data collection and statistical analyses A retrospective analysis method was employed, involving data collection from paediatric trauma patients admitted to our hospital's intensive care unit (ICU) between January 1, 2009, and December 31, 2018. Data analyses were conducted using SPSS version 26.0. The statistical methodologies employed in this study comprised general descriptive analyses and independent samples t-tests for comparing means from two separate groups. Statistical significance was set at P < 0.05. Results Characteristics and demographics of paediatric trauma cases Over the 10-year period from January 1, 2009, to December 31, 2018, a total of 951 paediatric patients aged 0–18 years were enrolled. They had a mean age of 4.79 ± 3.24 years and a mean weight of 18.45 ± 9.02 kg. Males and females accounted for 60.78% and 39.22%, respectively. The majority of the patients were from rural areas (64.35%), while the smallest proportion was from urban locales (16.72%). Regarding residency status, local residents formed the largest group (79.81%), whereas migrant workers represented the smallest proportion (20.19%). By age group, children under 6 years old were the most prevalent (70.77%), while those aged 12–18 years were the least represented (2.84%). The majority of injuries occurred on roadsides (49.00%), with the fewest occurring at schools (0.74%). Regarding injury types, single-site injuries dominated (58.78%) over multiple-site injuries (41.22%), with head injuries being the most frequent (81.57%), followed by abdominal (6.08%), respiratory-lung (5.90%), pelvic (2.86%), limb (2.68%), spinal (0.54%), and arterial (0.37%) injuries. Injury incidents peaked between 12 PM and 6 PM (44.48%) and were minimal from 12 AM to 6 AM (1.89%). There was a higher daily average of injuries (18.82%) on non-workdays than on workdays (12.47%). Winter had the fewest injury cases (19.24%). Traffic accidents were the leading cause of injury (47.95%), while electric shock was the least common (0.11%). Detailed information is provided in Table 1 . Table 1 Demographic and Contextual Characteristics of Paediatric Patients with Trauma (n = 951) n Percentage (%) Sex Male 578 60.78 Female 373 39.22 Residence Urban 159 16.72 Suburban-Rural Fringe 180 18.93 Rural Resident 612 64.35 Identity Local 759 79.81 Migrant Worker 192 20.19 Age Group Under 6 Years 673 70.77 6–12 Years 251 26.39 12–18 Years 27 2.84 Injury Location School 7 0.74 Home/Dormitory 403 42.38 Roadside 466 49.00 Public Place 66 6.94 Others 9 0.94 Injury Site Multiple Sites 392 41.22 Single Site 559 58.78 Time of Injury 0–6 AM 18 1.89 6–12 AM 300 31.55 12–18 PM 423 44.48 18–24 PM 210 22.08 Injury Day Weekday 593 62.36 Weekend 358 37.64 Injury Season Spring 258 27.13 Summer 256 26.92 Autumn 254 26.71 Winter 183 19.24 Cause of Injury Traffic Injury 456 47.95 Fall Injury 404 42.48 Burn/Scald 50 5.26 Explosion Injury 6 0.63 Sharp Object Injury 11 1.16 Animal Attack 2 0.21 Electric Shock 1 0.11 Others 21 2.20 The mean time to ICU admission post-injury was 10.86 ± 14.95 hours. Among the patients, 422 (44.4%) required emergency surgery and 466 (49%) needed mechanical ventilation, with a mean duration of 70.19 ± 146.62 hours. The mean ICU stay was 6.24 ± 8.01 days, and the overall hospital stay averaged 16.08 ± 15.56 days. At ICU admission, the mean injury severity score was 18.49 ± 8.86. Following the active intervention, 871 patients (91.59%) improved, while 80 (8.41%) succumbed to their injuries. Different injury characteristics across various age groups There were significant differences in sex and time of injury among age groups. Notably, the number of boys was significantly higher in the ‘6–12 years’ age group than in the ‘under 6 years’ group (P < 0.05). Furthermore, there was a higher proportion of children injured during the ‘6–12 AM’ period in the ‘Under 6 years’ group than in the ‘6–12 years’ group (P < 0.05). Detailed information is provided in Table 2 . Table 2 Distribution of Injury Characteristics across Different Age Groups Under 6 Years 6–12 Years 12–18 Years χ 2 Value P Value Sex 6.941 0.031 Male 391 (58.1) 169 (67.3) a 18 (66.7) Female 282 (41.9) 82 (32.7) a 9 (33.3) Residence 1.334 0.856 Urban 112 (16.6) 44 (17.5) 3 (11.1) Suburban-Rural Fringe 124 (18.4) 51 (20.3) 5 (18.5) Rural Resident 437 (64.9) 156 (62.2) 19 (70.4) Identity 2.195 0.334 Local 529 (78.6) 207 (82.5) 23 (85.2) Migrant Worker 144 (21.4) 44 (17.5) 4 (14.8) Time of Injury 15.618 0.016 0–6 AM 11 (1.6) 5 (2.0) 2 (7.4) 6–12 AM 229 (34) 61 (24.3) a 10 (37.0) 12–18 PM 292 (43.4) 124 (49.4) 7 (25.9) 18–24 PM 141 (21) 61 (24.3) 8 (29.6) Injury Day 2.130 0.345 Weekday 422 (62.7) 151 (60.2) 20 (74.1) Weekend 251 (37.3) 100 (39.8) 7 (25.9) Injury Season 6.154 0.406 Spring 185 (27.2) 68 (27.1) 5 (18.5) Summer 184 (28.4) 61 (24.3) 11 (40.7) Autumn 183 (26.4) 64 (25.5) 7 (25.9) Winter 121 (18.1) 58 (23.1) 4 (14.8) Note: Data are presented as n (%). a Compared with the ‘Under 6 Years’ group, P < 0.05. Significant intergroup variations were also observed regarding injury causes, injury locations, and outcomes across different age groups (P < 0.05). Specifically, the proportion of children who experienced traffic injuries was higher in the ‘6–12 years’ age group than in the ‘under 6 years’ and ‘12–18 years’ groups (P < 0.05). Regarding injury location, a greater percentage of children were injured at home in the ‘under 6 years’ group than in the ‘6–12 years’ group (P < 0.05), whereas fewer children sustained injuries on roadsides in the ‘under 6 years’ than in the ‘6–12 years’ group (p < 0.05). Regarding outcomes, a higher proportion of children showed improvement in both the ‘6–12 years’ and ‘12–18 years’ groups than in the ‘under 6 years’ group (P 0.05). Detailed results are presented in Table 3 . Table 3 Injury Causes, Locations, and Outcomes across Age Groups Under 6 Years 6–12 Years 12–18 Years χ 2 Value P Value Cause of Injury 50.020 < 0.001 Traffic Injury 308 (45.8) 138 (55.0) a 10 (37.0) ab Fall Injury 296 (44) 93 (37.1) 15 (55.6) Burn/Scald 41 (6.1) 8 (3.2) 1 (3.7) Explosion Injury 3 (0.4) 3 (1.2) 0 (0.0) Sharp Object Injury 10 (1.5) 1 (0.4) 0 (0.0) Animal Attack 1 (0.1) 1 (0.4) 0 (0.0) Electric Shock 0 (0.0) 0 (0.0) 1 (3.7) Others 14 (2.1) 7 (2.8) 0 (0.0) Injury Location 21.692 0.006 School 3 (0.4) 4 (0.4) 0 (0.0) Home/Dormitory 310 (46.1) 79 (31.5) a 14 (51.9) Roadside 313 (46.5) 143 (57.0) a 10 (37.0) Public Place 42 (6.2) 21 (8.4) 3 (11.1) Others 5 (0.7) 4 (1.6) 0 (0.0) Outcomes 15.939 < 0.001 Improved 601 (89.3) 243 (96.8) a 27 (100) ab Died 72 (10.7) 8 (3.2) 0 (0.0) Note: Data are presented as n (%). a Compared with the ‘Under 6 Years’ group, P < 0.05; b Compared with the ‘6–12 Years’ group, P < 0.05. Distribution of injury types by sex, residence, identity, and outcomes Upon analysing the distribution of various injury causes, we found no significant differences across groups in terms of sex, place of residence, resident status, or outcome indicators (P > 0.05). Details are provided in Table 4 . Table 4 Distribution of Injury Types by Sex, Residence, Identity, and Outcome Traffic Injury Fall Injury Burn/Scald Explosion Injury Sharp Object Injury Sharp Object Injury Electric Shock Others χ 2 Value P Value Sex 2.859 0.898 Male 277 (60.7) 247 (61.1) 30 (60.0) 4 (66.7) 6 (54.5) 2 (100) 1 (100) 11 (52.4) Female 179 (39.3) 157 (38.9) 20 (40.0) 2 (33.3) 5 (45.5) 0 (0.0) 0 (0.0) 10 (47.6) Residence 12.762 0.545 Urban 71 (15.6) 72 (17.8) 8 (16.0) 3 (50.0) 3 (27.3) 0 (0.0) 0 (0.0) 2 (9.5) Suburban-Rural Fringe 80 (17.5) 86 (21.3) 9 (18.0) 1 (16.7) 1 (9.1) 0 (0.0) 0 (0.0) 3 (14.3) Rural Resident 305 (66.9) 246 (60.9) 33 (66.0) 2 (33.3) 7 (63.6) 2 (100) 1 (100) 16 (76.2) Identity Local 365 (80.0) 324 (80.2) 37 (74.0) 5 (83.3) 7 (63.6) 2 (100) 1 (100) 18 (85.7) Migrant Worker 91 (20.0) 80 (19.8) 13 (26.0) 1 (16.7) 4 (36.4) 0 (0.0) 0 (0.0) 3 (14.3) Outcome 4.400 0.733 Improved 412 (90.4) 371 (91.8) 48 (96.0) 6 (100) 11 (100) 2 (100) 1 (100) 20 (95.2) Died 44 (9.6) 33 (8.2) 2 (4.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 1 (4.8) Data are presented as n (%). Discussion To elucidate the epidemiological characteristics of childhood trauma, we conducted a retrospective analysis of paediatric trauma patients admitted to our hospital's ICU from January 1, 2009, to December 31, 2018. A total of 951 trauma cases were included, with a male-to-female ratio of 1.55:1, highlighting a slight predominance of boys among trauma victims; this finding is consistent with that in a previous study [ 13 ]. Further stratification analysis by age revealed a significantly higher proportion of boys in the ‘6–12 years’ age group than in the ‘under 6 years’ group. Boys are recognised as a high-risk group for accidental injuries, and those aged 6–12 years, who are more energetic and curious about their surroundings, are prone to engage in high-risk behaviours that increase their injury risk. This sex disparity in childhood injuries is a global phenomenon that tends to intensify with age. Our findings echoed existing literature [ 14 – 16 ], with the majority of the injured children (673 cases, 70.77%) being under 6 years old. This prevalence aligns with developmental stages at this age [ 17 ], where children under 6 years old have limited environmental awareness and motor skills, coupled with an inadequate understanding of danger, necessitating close supervision [ 18 ]. As children mature, improved abilities contribute to reduced trauma incidence [ 19 ]. Infants, unable to communicate and reliant on caregivers for their needs, face heightened risks of traffic accidents, falls, and burns/scalds. Consequently, developmental characteristics pertinent to paediatric trauma should guide prevention strategies and be integral to all injury prevention initiatives. In our study, traffic accidents emerged as the leading cause of trauma, followed by falls, burns/scalds, blast injuries, sharp object injuries, animal attacks, and electrical injuries. Consistently, road traffic accidents are the principal cause of unintentional deaths among children aged 0–14 years in developed countries [ 20 , 21 ]. Notably, within our sample, the ‘6–12 years’ age group had a higher incidence of traffic-related injuries than the ‘under 6 years’ and ‘12–18 years’ groups. Children aged 6–12 years, transitioning from kindergarten to primary school, have an expanded range of activities, heightened curiosity, weaker self-control, and insufficient understanding of traffic safety. Since the early 1990s, alongside improved living standards in China, there has been a surge in vehicle production, consequently leading to a rise in traffic injury-related mortality and morbidity rates [ 22 ]. To address traffic injuries, recurrent training for drivers on relevant regulations and raising public awareness are imperative. Additionally, traffic authorities and educational institutions should enhance traffic management and increase education on child traffic safety to elevate children's awareness. Studies suggest that high fatality rates from traffic injuries in China may be related to the low usage of child safety seats and seat belts [ 23 ]. In China, it is common practice for adults to hold infants on the front passenger seat, exposing them to direct airbag impact in case of accidents. Thus, the current traffic laws emphasise the use of child safety seats and seat belts in vehicles [ 24 , 25 ]. Falls, ranking second to traffic injuries, occur in children mainly due to accidents; in contrast, in adults, intentional falls (such as suicide) are more common [ 26 ]. Factors contributing to paediatric falls include increased incidents in high-rise living; lack of protective barriers around balconies, windows, and staircases; and children's curiosity-driven risky behaviours, such as climbing [ 27 ]. Installing guardrails on balconies and windows in high-rise apartments, placing carpets to soften falls, and rounding furniture edges can help reduce the risk of injuries. Additionally, enhancing children's motor skills through supervised climbing and tumbling exercises can minimise falling risks. Regarding injury aetiology, burn/scald injuries, blast injuries, sharp object injuries, animal attacks, and electrocutions exhibit clear regional characteristics, with a significantly higher incidence among children residing in rural or peri-urban areas than among urban children. Tailored intervention strategies can be formulated by compiling paediatric trauma data and understanding its epidemiological features [ 28 ]. Effective preventive guidance is derived from comprehensive datasets detailing injuries, which illuminate the shifting risks children encounter throughout their development. Some evidence suggests that burns are the second most common cause of unintentional childhood injuries [ 29 ]. In our study, burn/scald injuries ranked third after traffic accidents and falls. The lower rate of ICU admission due to burns/scalds than due to traffic injuries and falls reflects the possible nature of paediatric burns, which are often caused by hot water at home rather than by fires or chemicals. Childhood burns/scalds are influenced not only by age, sex, environment, and behaviour but also by parents' socioeconomic status and education level. Accumulating evidence suggests that 90% of paediatric burns/scalds occur within the home, underscoring the importance of proper first aid knowledge in such scenarios [ 30 ]. Our findings revealed that the top three injury locations were roadsides (466 cases, 49.0%), homes (403 cases, 42.4%), and public places (66 cases, 6.9%). The ‘under 6 years’ group sustained more injuries at home than the ‘6–12 years’ group, while the ‘under 6 years’ group experienced fewer injuries on roadsides than the ‘6–12 years’ group, aligning with the injury causes discussed. Hence, reinforcing traffic safety awareness, enhancing child supervision, and broadly disseminating safety education are of utmost importance. Our analysis of the timing of injuries found that 423 cases (44.5%) occurred between 12 PM and 6 PM, and Saturdays (96 cases, 20.6%) and Sundays (162 cases, 17.0%) showed significantly higher incidences than weekdays, indicating a heightened rate of trauma during non-working days. Furthermore, studies in developing countries have identified inadequate supervision, lower safety standards of household items, insufficient public safety warnings, and uneven road surfaces as risk factors for paediatric trauma [ 31 , 32 ]; these issues necessitate a more comprehensive investigation to better understand the myriad causes of child injuries in low- and middle-income nations [ 33 , 34 ]. Seasonally, winter showed a relatively lower trauma incidence, likely due to reduced outdoor activities because of colder weather. Notably, among children aged 12–18 years, a higher likelihood of trauma was observed from June through August, coinciding with the nearly two-month-long summer vacations. During this period, children aged ≥ 12 years gain more independence in mobility, highlighting the imperative for intensified safety education during these months. Among the 951 paediatric patients, ‘single site injuries’ (58.78%) were more prevalent than ‘multiple-site injuries’ (41.22%), with head injuries constituting the primary type among single-site traumas (81.57%), followed by abdominal and thoracic injuries. Cranio-cerebral trauma, a common and critical condition in emergency medicine [ 35 – 37 ], is categorised into various forms, including epidural hematoma, subdural hematoma, traumatic subarachnoid haemorrhage, and severe cerebral contusions. These conditions necessitate prompt intervention due to their severity, high mortality, and disability rates [ 38 , 39 ]. In the United States, approximately 500,000 children annually present to emergency departments for head injuries, with approximately 7,000 fatalities [ 40 ]. In our study, 529 patients (55.6%) underwent emergency surgical intervention. Trauma can lead to various complications, with respiratory failure being the most frequent [ 41 ]. Notably, in our study cohort, 466 patients (49%) required mechanical ventilation, with an average duration of 70.19 ± 146.62 hours, indicating that invasive ventilation complications significantly impact the duration of ICU stays [ 42 ]. Childhood trauma incidence is intricately linked with economic, cultural, behavioural, and living conditions [ 43 – 45 ]. Prior research has exhibited distinct geographic and demographic patterns in childhood trauma incidence. Our study also discerned variances in injury types and causes among urban, suburban-rural fringe, and rural children, with a lower incidence in urban and suburban-rural fringe areas than in rural locales. Despite China's rapid economic progress, which has narrowed the urban-rural gap, trauma incidence remains disproportionately high in rural areas. Prolonged transportation times to urban medical facilities and less advanced emergency care in rural regions contribute to this discrepancy. In rural areas, traffic restrictions can lead to prolonged transit times for children needing medical attention in urban centres, thereby delaying access to optimal intervention periods. Moreover, the relative inadequacy of local emergency response facilities and technological capabilities further contributes to this disparity. Another report highlights that left-behind children (those residing in rural China while their parents work in cities, typically cared for by extended family members such as grandparents or other close relatives) face a significantly higher risk of injury than their urban counterparts. [ 46 ] This study, confined to a single-centre retrospective summary over nearly a decade, inherently limits its scope in comprehensively depicting the characteristics of trauma. Expanding to a nationwide, multicentre, prospective investigation encompassing diverse geographic regions would afford a broader perspective, enabling a deeper understanding of the current state of trauma in China. Such an endeavour would not only provide a more nuanced picture of trauma epidemiology but also illuminate the effectiveness of educational campaigns, policy improvements, and other preventive measures in mitigating the burden of trauma across the country. Paediatric trauma constitutes a major public health concern, representing a substantial proportion of unintentional injuries and exhibiting an alarming upward trend in recent years [ 47 ]. Traffic injuries stand as the paramount cause of paediatric trauma, underscoring the ongoing significance of appropriate utilisation of child restraint systems and protective equipment in prevention efforts. The heightened vulnerability of children under 6 years old and those residing in rural areas, with correspondingly higher injury rates, highlights the pressing need for targeted preventive strategies and public policies tailored to these high-risk demographics. A more thorough comprehension of the characteristics of paediatric trauma can facilitate enhanced public awareness campaigns and educational initiatives, leading to more efficacious prevention measures. The literature has documented that the establishment of trauma systems can reduce mortality rates by 15% [ 48 ], emphasising the imperative to strengthen rural healthcare systems and capabilities. Efforts must be directed toward enhancing medical institutions' capacity to provide advanced care for injured children and ensuring efficient patient transfer, collaboratively working to mitigate the multifaceted physiological and psychological impacts that trauma inflicts upon these young patients. Conclusions In this study, we found that traffic injuries were the paramount cause of paediatric trauma, followed closely by falls. Children under the age of 6 years were most commonly affected by trauma incidents, with boys experiencing a higher incidence rate. Moreover, rural regions showed a heightened occurrence of paediatric trauma compared to urban areas. Traumatic injuries primarily involved head trauma and multiple complex injuries, with non-working days and the afternoon hours between 12 PM and 6 PM marking the peak periods for such incidents. Abbreviations ICU, intensive care unit Declarations Ethics approval and consent to participate: This study adhered to the principles of the Declaration of Helsinki and was approved by the ethics committee of the children's hospital affiliated with Zhejiang University School of Medicine (Hangzhou, China; approval number: 2024-IRB-0127-P-01). Consent for publication: Given this study’s retrospective nature and minimal risk, written informed consent was waived. Availability of data and materials: The data can be found online at https://doi: 10.17632/7mvzk58ctj.2 Competing interests: All authors are Editorial Board members of the World Journal of Emergency Surgery and were excluded from the peer review process for this article. Funding: This work was supported by the grants from the Key Program of The Independent Design Project of National Clinical Research Center for Child Health. [No. G20B0009 (Linhua Tan)]. Authors' contributions: All collaborators participated in drafting the manuscript, and all individuals agreed to its submission. The corresponding author attests that all listed collaborators meet the required criteria and that no others have been omitted. Acknowledgements: We would like to thank Editage (www.editage.cn) for English language editing. References Guice KS, Cassidy LD, Oldham KT. 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A Study on Epidemiology of Unintentional Childhood Injury at One of the Districts of Gujarat State: An Indian Council of Medical Research Task Force Study. Indian J Commun Med. 2022;47:187–91. 10.4103/ijcm.ijcm_1275_21 . Ye J, Bao Y, Zheng J, et al. Epidemiology of unintentional injury in children admitted to ICU in China mainland: a multi-center cross-sectional study. Transl Pediatr. 2022;11:340–8. 10.21037/tp-21-387 . Sawe HR, Milusheva S, Croke K, et al. Pediatric trauma burden in Tanzania: analysis of prospective registry data from thirteen health facilities. Inj Epidemiol. 2022;9:3. 10.1186/s40621-022-00369-7 . Brugnolaro V, Fovino LN, Calgaro S, et al. Pediatric emergency care in a low-income country: Characteristics and outcomes of presentations to a tertiary-care emergency department in Mozambique. PLoS ONE. 2020;15:e0241209. 10.1371/journal.pone.0241209 . Payr S, Schuller A, Dangl T, et al. Maintaining medical resources to treat paediatric injuries during COVID-19 lockdown is essential-An epidemiological analysis of a level 1 trauma centre in central Europe. Int J Environ Res Public Health. 2021;18:5829. 10.3390/ijerph18115829 . Plumblee L, Williams R, Vane D, et al. Isolated low-grade solid organ injuries in children following blunt abdominal trauma: Is it time to consider discharge from the emergency department? J Trauma Acute Care Surg. 2020;89:887–93. 10.1097/TA.0000000000002899 . Fairbrother H, Morrissey K. Severe traumatic brain injury in children: an evidence-based review of emergency department management. Pediatr Emerg Med Pract. 2024; 21: 1–28 PMID: 38885364. Purohit D, Sinha V, Karthikeyan Y. Role of magnetic resonance imaging in unconscious patients due to diffuse axonal injury and its prognostic value. Indian J Neurotraum. 2024;14:015–20. 10.1055/s-0037-1604051 . Woods A, Sheikh Y, Quinn N, et al. CT brain interpretation in paediatric trauma. Arch Dis Child Educ Pract Ed. 2024. 10.1136/archdischild-2023-326674 . edpract-2023-326674. The Brain Trauma Foundation. The American Association of Neurological Surgeons. The Joint Section on Neurotrauma and Critical Care. Indications for intracranial pressure monitoring. J Neurotraum. 2000;17:479–91. 10.1089/neu.2000.17.479 . Rattan A, Joshi MK, Mishra B, et al. Profile of injuries in children: Report from a level I trauma center. Indian Pediatr. 2021;58:553–5. PMID: 32893835. Böhmer AB, Just KS, Lefering R, et al. Factors influencing lengths of stay in the intensive care unit for surviving trauma patients: a retrospective analysis of 30,157 cases. Crit Care. 2014;18:R143. 10.1186/cc13976 . Cazacu-Stratu A, Cociu S, Plamadeala A, ATTITUDES, AND PRACTICES REGARDING HOME-RELATED INJURES IN CHILDREN UNDER 5 YEARS OLD]. [PARENT'S KNOWLEDGE. One Health Risk Manag. 2023;4:40–5. 10.38045/ohrm.2023.2.06 . Yu X, Wang Y, He C, et al. The trend of unintentional injury-related mortality among children aged under-five years in China, 2010–2020: a retrospective analysis from a national surveillance system. BMC Public Health. 2023;23:673. 10.1186/s12889-023-15546-6 . Zhang H, Bai F, Song H, et al. Cumulative effect of risk and protective factors on unintentional injury for Chinese rural children: a nested case-control study. BMC Public Health. 2021;21:1730. 10.1186/s12889-021-11769-7 . Yang L, Nong QQ, Li CL, et al. Risk factors for childhood drowning in rural regions of a developing country: a case- control study. Inj Prev. 2007;13:178–82. 10.1136/ip.2006.013409 . Jiang X, Zhang Y, Wang Y, et al. An analysis of 6215 hospitalized unintentional injuries among children aged 0–14 in northwest China. Accid Anal Prev. 2010;42:320–6. 10.1016/j.aap.2009.08.012 . Celso B, Tepas J, Langland-Orban B, et al. A systematic review and meta-analysis comparing outcome of severely injured patients treated in trauma centers following the establishment of trauma systems. J Trauma. 2006;60:371–8. 10.1097/01.ta.0000197916.99629.eb . discussion 378. Additional Declarations No competing interests reported. Supplementary Files STROBEchecklistv4combinedPlosMedicine.docx Cite Share Download PDF Status: Under Review Version 1 posted Editor assigned by journal 12 Jul, 2024 Submission checks completed at journal 12 Jul, 2024 First submitted to journal 09 Jul, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4713267","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":325958926,"identity":"5d6023c4-66bf-4637-9081-7efd6c8c3334","order_by":0,"name":"Yiyao Bao","email":"","orcid":"","institution":"Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":false,"prefix":"","firstName":"Yiyao","middleName":"","lastName":"Bao","suffix":""},{"id":325958927,"identity":"6ae992f2-aa6a-4762-8ff4-8b8db68f86b3","order_by":1,"name":"Jing Ye","email":"","orcid":"","institution":"Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":false,"prefix":"","firstName":"Jing","middleName":"","lastName":"Ye","suffix":""},{"id":325958928,"identity":"da28f2af-40df-4160-943d-5c670ade26f7","order_by":2,"name":"Lei Hu","email":"","orcid":"","institution":"Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":false,"prefix":"","firstName":"Lei","middleName":"","lastName":"Hu","suffix":""},{"id":325958929,"identity":"02083953-327a-4b34-9b0f-f3a0a38f33b5","order_by":3,"name":"Lijun Guan","email":"","orcid":"","institution":"Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":false,"prefix":"","firstName":"Lijun","middleName":"","lastName":"Guan","suffix":""},{"id":325958931,"identity":"362ff09b-8235-41c0-b2d5-9171deecb969","order_by":4,"name":"Caina Gao","email":"","orcid":"","institution":"Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":false,"prefix":"","firstName":"Caina","middleName":"","lastName":"Gao","suffix":""},{"id":325958933,"identity":"a6838b0c-5431-4416-9cfd-5941a07805fa","order_by":5,"name":"Linhua Tan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAtUlEQVRIiWNgGAWjYDACCQbGwwwVDMwQNnFamBkOM5whWQtjG8xGYgD/7P4Dhwvn1bEbHGA+eJuHwS6PsCV3DjMcnrmNjdngAFuyNQ9DcjFBLQYSyQyHebfxALXwmEnzMBxIbCBOyxwJoBb+b6RoaTAA2cJGnBaJG8kGh3mOJTBLHmYztpxjkExYC/+MxIePeWrqkvmONz+88abCjrAWGEiGRKYBseqBwI4EtaNgFIyCUTDSAACE8TQoB8EhggAAAABJRU5ErkJggg==","orcid":"","institution":"Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":true,"prefix":"","firstName":"Linhua","middleName":"","lastName":"Tan","suffix":""}],"badges":[],"createdAt":"2024-07-09 15:44:27","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4713267/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4713267/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":61889088,"identity":"11dd79d8-4f4d-441a-abd1-f6524c771e86","added_by":"auto","created_at":"2024-08-06 17:45:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":788008,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4713267/v1/2fa7e995-83a4-4d83-9c6f-096e70eef8ae.pdf"},{"id":61888806,"identity":"5da86283-c9b1-4053-abfb-a63dad90ab08","added_by":"auto","created_at":"2024-08-06 17:37:25","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":131795,"visible":true,"origin":"","legend":"","description":"","filename":"STROBEchecklistv4combinedPlosMedicine.docx","url":"https://assets-eu.researchsquare.com/files/rs-4713267/v1/d69ad873ecc24659ea05d12c.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Epidemiological Analysis of Paediatric Trauma in Intensive Care: A 10-Year Retrospective Study from 2009 to 2018","fulltext":[{"header":"Background","content":"\u003cp\u003eTrauma is defined as the disruption of human tissues or organs caused by mechanical forces [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. It encompasses a broad spectrum of external bodily injuries in children, including those resulting from road traffic accidents, falls, blunt forces, cuts, sprains, burns, and abuse, typically occurring unexpectedly. It is the leading cause of unintentional injury during childhood and a pivotal cause of paediatric mortality [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. It is reported that approximately 830,000 children die from unintentional injuries annually [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. In the United States, approximately 22\u0026nbsp;million children, or one-third of the child population, experience such injuries annually [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. On average, there are approximately 6,000 children (aged 0\u0026ndash;14 years) who die from injuries annually in the European Union [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In China, trauma accounts for 21.26% of paediatric injuries, with a mortality rate of 28.12 per 100,000 [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Trauma has surpassed other diseases to become the most common cause of death or morbidity among children and adolescents [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], imposing a significant physical and psychological burden on the affected children and their families [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe risk factors and characteristics of paediatric trauma vary between developed and developing countries, influenced by social resources and economic conditions. Consequently, prevention and treatment strategies developed in wealthy nations may not be universally applicable to less prosperous ones. Research suggests that up to 90% of traumas can be prevented through effective interventions [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Trauma is influenced by multifactorial elements, including individual, familial, societal, and regional factors, and exhibits regional peculiarities with correlations with geographical and economic contexts. The causes of trauma also differ according to age, sex, and living environment [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Therefore, gaining a thorough understanding of the factors contributing to paediatric trauma and meticulously analysing the triggers and types of injuries are crucial for implementing more effective preventive measures, safeguarding children\u0026rsquo;s lives, and fostering a secure and harmonious environment conducive to their healthy development. The significance of this study and other information may help guide prevention strategies aimed at reducing the incidence of accidental injuries among children in the Chinese mainland. We present the following article in accordance with the STROBE reporting checklist.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eThe inclusion criteria were as follows: (1) timeframe, January 1, 2009 to December 31, 2018; (2) age\u0026thinsp;\u0026lt;\u0026thinsp;18 years; and (3) trauma resulting from falls, traffic incidents, machinery accidents, or other unintentional injuries, with the incident being the patient's first traumatic experience.\u003c/p\u003e \u003cp\u003eThe exclusion criteria were as follows: (1) intracranial injuries secondary to neurological disorders, such as spontaneous intracranial haemorrhage, brain tumours, and epilepsy; (2) pre-injury cardiac function classified as New York Heart Association Class II or higher, liver function categorised as Child-Pugh Class B or worse, or glomerular filtration rate\u0026thinsp;\u0026lt;\u0026thinsp;90 ml/min; and (3) presence of congenital metabolic disorders.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eData collection and statistical analyses\u003c/h2\u003e \u003cp\u003eA retrospective analysis method was employed, involving data collection from paediatric trauma patients admitted to our hospital's intensive care unit (ICU) between January 1, 2009, and December 31, 2018. Data analyses were conducted using SPSS version 26.0. The statistical methodologies employed in this study comprised general descriptive analyses and independent samples t-tests for comparing means from two separate groups. Statistical significance was set at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eCharacteristics and demographics of paediatric trauma cases\u003c/h2\u003e \u003cp\u003eOver the 10-year period from January 1, 2009, to December 31, 2018, a total of 951 paediatric patients aged 0\u0026ndash;18 years were enrolled. They had a mean age of 4.79\u0026thinsp;\u0026plusmn;\u0026thinsp;3.24 years and a mean weight of 18.45\u0026thinsp;\u0026plusmn;\u0026thinsp;9.02 kg. Males and females accounted for 60.78% and 39.22%, respectively. The majority of the patients were from rural areas (64.35%), while the smallest proportion was from urban locales (16.72%). Regarding residency status, local residents formed the largest group (79.81%), whereas migrant workers represented the smallest proportion (20.19%).\u003c/p\u003e \u003cp\u003eBy age group, children under 6 years old were the most prevalent (70.77%), while those aged 12\u0026ndash;18 years were the least represented (2.84%). The majority of injuries occurred on roadsides (49.00%), with the fewest occurring at schools (0.74%). Regarding injury types, single-site injuries dominated (58.78%) over multiple-site injuries (41.22%), with head injuries being the most frequent (81.57%), followed by abdominal (6.08%), respiratory-lung (5.90%), pelvic (2.86%), limb (2.68%), spinal (0.54%), and arterial (0.37%) injuries.\u003c/p\u003e \u003cp\u003eInjury incidents peaked between 12 PM and 6 PM (44.48%) and were minimal from 12 AM to 6 AM (1.89%). There was a higher daily average of injuries (18.82%) on non-workdays than on workdays (12.47%). Winter had the fewest injury cases (19.24%). Traffic accidents were the leading cause of injury (47.95%), while electric shock was the least common (0.11%). Detailed information is provided in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic and Contextual Characteristics of Paediatric Patients with Trauma (n\u0026thinsp;=\u0026thinsp;951)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e578\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e60.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e373\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e39.22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e16.72\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuburban-Rural Fringe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e18.93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural Resident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e612\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e64.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIdentity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e759\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e79.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMigrant Worker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e20.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge Group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnder 6 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e673\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e70.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u0026ndash;12 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e26.39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12\u0026ndash;18 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e2.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInjury Location\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSchool\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHome/Dormitory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e403\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e42.38\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRoadside\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e466\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e49.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePublic Place\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e6.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInjury Site\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMultiple Sites\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e392\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41.22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSingle Site\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e559\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e58.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTime of Injury\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e0\u0026ndash;6 AM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e6\u0026ndash;12 AM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.55\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e12\u0026ndash;18 PM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e423\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e44.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e18\u0026ndash;24 PM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInjury Day\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eWeekday\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e593\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e62.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eWeekend\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInjury Season\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSpring\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e258\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSummer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e256\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.92\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAutumn\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eWinter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCause of Injury\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eTraffic Injury\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.95\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFall Injury\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e404\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eBurn/Scald\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eExplosion Injury\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSharp Object Injury\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAnimal Attack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eElectric Shock\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe mean time to ICU admission post-injury was 10.86\u0026thinsp;\u0026plusmn;\u0026thinsp;14.95 hours. Among the patients, 422 (44.4%) required emergency surgery and 466 (49%) needed mechanical ventilation, with a mean duration of 70.19\u0026thinsp;\u0026plusmn;\u0026thinsp;146.62 hours. The mean ICU stay was 6.24\u0026thinsp;\u0026plusmn;\u0026thinsp;8.01 days, and the overall hospital stay averaged 16.08\u0026thinsp;\u0026plusmn;\u0026thinsp;15.56 days. At ICU admission, the mean injury severity score was 18.49\u0026thinsp;\u0026plusmn;\u0026thinsp;8.86. Following the active intervention, 871 patients (91.59%) improved, while 80 (8.41%) succumbed to their injuries.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eDifferent injury characteristics across various age groups\u003c/h2\u003e \u003cp\u003eThere were significant differences in sex and time of injury among age groups. Notably, the number of boys was significantly higher in the \u0026lsquo;6\u0026ndash;12 years\u0026rsquo; age group than in the \u0026lsquo;under 6 years\u0026rsquo; group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Furthermore, there was a higher proportion of children injured during the \u0026lsquo;6\u0026ndash;12 AM\u0026rsquo; period in the \u0026lsquo;Under 6 years\u0026rsquo; group than in the \u0026lsquo;6\u0026ndash;12 years\u0026rsquo; group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Detailed information is provided in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of Injury Characteristics across Different Age Groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnder 6 Years\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u0026ndash;12 Years\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u0026ndash;18 Years\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.941\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e391 (58.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e169 (67.3)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e282 (41.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82 (32.7)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.334\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.856\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e112 (16.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44 (17.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuburban-Rural Fringe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e124 (18.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51 (20.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (18.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural Resident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e437 (64.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e156 (62.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (70.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIdentity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.334\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e529 (78.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e207 (82.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (85.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMigrant Worker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e144 (21.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44 (17.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (14.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTime of Injury\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.618\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;6 AM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (7.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u0026ndash;12 AM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e229 (34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61 (24.3)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (37.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12\u0026ndash;18 PM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e292 (43.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e124 (49.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (25.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;24 PM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e141 (21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61 (24.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (29.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInjury Day\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.345\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeekday\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e422 (62.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e151 (60.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (74.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeekend\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e251 (37.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100 (39.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (25.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInjury Season\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.406\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpring\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e185 (27.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68 (27.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (18.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSummer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e184 (28.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61 (24.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (40.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAutumn\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e183 (26.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64 (25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (25.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWinter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e121 (18.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58 (23.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (14.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote: Data are presented as n (%).\u003csup\u003ea\u003c/sup\u003e Compared with the \u0026lsquo;Under 6 Years\u0026rsquo; group, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSignificant intergroup variations were also observed regarding injury causes, injury locations, and outcomes across different age groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Specifically, the proportion of children who experienced traffic injuries was higher in the \u0026lsquo;6\u0026ndash;12 years\u0026rsquo; age group than in the \u0026lsquo;under 6 years\u0026rsquo; and \u0026lsquo;12\u0026ndash;18 years\u0026rsquo; groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Regarding injury location, a greater percentage of children were injured at home in the \u0026lsquo;under 6 years\u0026rsquo; group than in the \u0026lsquo;6\u0026ndash;12 years\u0026rsquo; group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), whereas fewer children sustained injuries on roadsides in the \u0026lsquo;under 6 years\u0026rsquo; than in the \u0026lsquo;6\u0026ndash;12 years\u0026rsquo; group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Regarding outcomes, a higher proportion of children showed improvement in both the \u0026lsquo;6\u0026ndash;12 years\u0026rsquo; and \u0026lsquo;12\u0026ndash;18 years\u0026rsquo; groups than in the \u0026lsquo;under 6 years\u0026rsquo; group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). All other comparisons showed no significant differences (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Detailed results are presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInjury Causes, Locations, and Outcomes across Age Groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnder 6 Years\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u0026ndash;12 Years\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u0026ndash;18 Years\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCause of Injury\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e50.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTraffic Injury\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e308 (45.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e138 (55.0)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (37.0)\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFall Injury\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e296 (44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93 (37.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (55.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBurn/Scald\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41 (6.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExplosion Injury\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSharp Object Injury\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnimal Attack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElectric Shock\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInjury Location\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.692\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSchool\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHome/Dormitory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e310 (46.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79 (31.5)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (51.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRoadside\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e313 (46.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e143 (57.0)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (37.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePublic Place\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 (6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (8.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOutcomes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.939\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImproved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e601 (89.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e243 (96.8)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27 (100)\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72 (10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote: Data are presented as n (%). \u003csup\u003ea\u003c/sup\u003e Compared with the \u0026lsquo;Under 6 Years\u0026rsquo; group, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05; \u003csup\u003eb\u003c/sup\u003e Compared with the \u0026lsquo;6\u0026ndash;12 Years\u0026rsquo; group, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eDistribution of injury types by sex, residence, identity, and outcomes\u003c/h2\u003e \u003cp\u003eUpon analysing the distribution of various injury causes, we found no significant differences across groups in terms of sex, place of residence, resident status, or outcome indicators (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Details are provided in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of Injury Types by Sex, Residence, Identity, and Outcome\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTraffic Injury\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFall Injury\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBurn/Scald\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eExplosion Injury\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSharp Object Injury\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSharp Object Injury\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eElectric Shock\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.859\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.898\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e277 (60.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e247 (61.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30 (60.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 (54.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e11 (52.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e179 (39.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e157 (38.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (45.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e10 (47.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e12.762\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.545\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71 (15.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72 (17.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (27.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 (9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuburban-Rural Fringe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 (17.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86 (21.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (18.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (9.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3 (14.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural Resident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e305 (66.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e246 (60.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33 (66.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 (63.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e16 (76.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIdentity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e365 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e324 (80.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37 (74.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 (63.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e18 (85.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMigrant Worker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e91 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80 (19.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (26.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 (36.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3 (14.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOutcome\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4.400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.733\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImproved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e412 (90.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e371 (91.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48 (96.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e20 (95.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (9.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 (8.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 (4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"11\"\u003eData are presented as n (%).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eTo elucidate the epidemiological characteristics of childhood trauma, we conducted a retrospective analysis of paediatric trauma patients admitted to our hospital's ICU from January 1, 2009, to December 31, 2018. A total of 951 trauma cases were included, with a male-to-female ratio of 1.55:1, highlighting a slight predominance of boys among trauma victims; this finding is consistent with that in a previous study [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Further stratification analysis by age revealed a significantly higher proportion of boys in the \u0026lsquo;6\u0026ndash;12 years\u0026rsquo; age group than in the \u0026lsquo;under 6 years\u0026rsquo; group. Boys are recognised as a high-risk group for accidental injuries, and those aged 6\u0026ndash;12 years, who are more energetic and curious about their surroundings, are prone to engage in high-risk behaviours that increase their injury risk. This sex disparity in childhood injuries is a global phenomenon that tends to intensify with age.\u003c/p\u003e \u003cp\u003eOur findings echoed existing literature [\u003cspan additionalcitationids=\"CR15\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], with the majority of the injured children (673 cases, 70.77%) being under 6 years old. This prevalence aligns with developmental stages at this age [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], where children under 6 years old have limited environmental awareness and motor skills, coupled with an inadequate understanding of danger, necessitating close supervision [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. As children mature, improved abilities contribute to reduced trauma incidence [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Infants, unable to communicate and reliant on caregivers for their needs, face heightened risks of traffic accidents, falls, and burns/scalds. Consequently, developmental characteristics pertinent to paediatric trauma should guide prevention strategies and be integral to all injury prevention initiatives.\u003c/p\u003e \u003cp\u003eIn our study, traffic accidents emerged as the leading cause of trauma, followed by falls, burns/scalds, blast injuries, sharp object injuries, animal attacks, and electrical injuries. Consistently, road traffic accidents are the principal cause of unintentional deaths among children aged 0\u0026ndash;14 years in developed countries [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Notably, within our sample, the \u0026lsquo;6\u0026ndash;12 years\u0026rsquo; age group had a higher incidence of traffic-related injuries than the \u0026lsquo;under 6 years\u0026rsquo; and \u0026lsquo;12\u0026ndash;18 years\u0026rsquo; groups. Children aged 6\u0026ndash;12 years, transitioning from kindergarten to primary school, have an expanded range of activities, heightened curiosity, weaker self-control, and insufficient understanding of traffic safety. Since the early 1990s, alongside improved living standards in China, there has been a surge in vehicle production, consequently leading to a rise in traffic injury-related mortality and morbidity rates [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. To address traffic injuries, recurrent training for drivers on relevant regulations and raising public awareness are imperative. Additionally, traffic authorities and educational institutions should enhance traffic management and increase education on child traffic safety to elevate children's awareness. Studies suggest that high fatality rates from traffic injuries in China may be related to the low usage of child safety seats and seat belts [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. In China, it is common practice for adults to hold infants on the front passenger seat, exposing them to direct airbag impact in case of accidents. Thus, the current traffic laws emphasise the use of child safety seats and seat belts in vehicles [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Falls, ranking second to traffic injuries, occur in children mainly due to accidents; in contrast, in adults, intentional falls (such as suicide) are more common [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Factors contributing to paediatric falls include increased incidents in high-rise living; lack of protective barriers around balconies, windows, and staircases; and children's curiosity-driven risky behaviours, such as climbing [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Installing guardrails on balconies and windows in high-rise apartments, placing carpets to soften falls, and rounding furniture edges can help reduce the risk of injuries. Additionally, enhancing children's motor skills through supervised climbing and tumbling exercises can minimise falling risks.\u003c/p\u003e \u003cp\u003eRegarding injury aetiology, burn/scald injuries, blast injuries, sharp object injuries, animal attacks, and electrocutions exhibit clear regional characteristics, with a significantly higher incidence among children residing in rural or peri-urban areas than among urban children. Tailored intervention strategies can be formulated by compiling paediatric trauma data and understanding its epidemiological features [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Effective preventive guidance is derived from comprehensive datasets detailing injuries, which illuminate the shifting risks children encounter throughout their development. Some evidence suggests that burns are the second most common cause of unintentional childhood injuries [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. In our study, burn/scald injuries ranked third after traffic accidents and falls. The lower rate of ICU admission due to burns/scalds than due to traffic injuries and falls reflects the possible nature of paediatric burns, which are often caused by hot water at home rather than by fires or chemicals. Childhood burns/scalds are influenced not only by age, sex, environment, and behaviour but also by parents' socioeconomic status and education level. Accumulating evidence suggests that 90% of paediatric burns/scalds occur within the home, underscoring the importance of proper first aid knowledge in such scenarios [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Our findings revealed that the top three injury locations were roadsides (466 cases, 49.0%), homes (403 cases, 42.4%), and public places (66 cases, 6.9%). The \u0026lsquo;under 6 years\u0026rsquo; group sustained more injuries at home than the \u0026lsquo;6\u0026ndash;12 years\u0026rsquo; group, while the \u0026lsquo;under 6 years\u0026rsquo; group experienced fewer injuries on roadsides than the \u0026lsquo;6\u0026ndash;12 years\u0026rsquo; group, aligning with the injury causes discussed. Hence, reinforcing traffic safety awareness, enhancing child supervision, and broadly disseminating safety education are of utmost importance.\u003c/p\u003e \u003cp\u003eOur analysis of the timing of injuries found that 423 cases (44.5%) occurred between 12 PM and 6 PM, and Saturdays (96 cases, 20.6%) and Sundays (162 cases, 17.0%) showed significantly higher incidences than weekdays, indicating a heightened rate of trauma during non-working days. Furthermore, studies in developing countries have identified inadequate supervision, lower safety standards of household items, insufficient public safety warnings, and uneven road surfaces as risk factors for paediatric trauma [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]; these issues necessitate a more comprehensive investigation to better understand the myriad causes of child injuries in low- and middle-income nations [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Seasonally, winter showed a relatively lower trauma incidence, likely due to reduced outdoor activities because of colder weather. Notably, among children aged 12\u0026ndash;18 years, a higher likelihood of trauma was observed from June through August, coinciding with the nearly two-month-long summer vacations. During this period, children aged\u0026thinsp;\u0026ge;\u0026thinsp;12 years gain more independence in mobility, highlighting the imperative for intensified safety education during these months.\u003c/p\u003e \u003cp\u003eAmong the 951 paediatric patients, \u0026lsquo;single site injuries\u0026rsquo; (58.78%) were more prevalent than \u0026lsquo;multiple-site injuries\u0026rsquo; (41.22%), with head injuries constituting the primary type among single-site traumas (81.57%), followed by abdominal and thoracic injuries. Cranio-cerebral trauma, a common and critical condition in emergency medicine [\u003cspan additionalcitationids=\"CR36\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], is categorised into various forms, including epidural hematoma, subdural hematoma, traumatic subarachnoid haemorrhage, and severe cerebral contusions. These conditions necessitate prompt intervention due to their severity, high mortality, and disability rates [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. In the United States, approximately 500,000 children annually present to emergency departments for head injuries, with approximately 7,000 fatalities [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. In our study, 529 patients (55.6%) underwent emergency surgical intervention. Trauma can lead to various complications, with respiratory failure being the most frequent [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Notably, in our study cohort, 466 patients (49%) required mechanical ventilation, with an average duration of 70.19\u0026thinsp;\u0026plusmn;\u0026thinsp;146.62 hours, indicating that invasive ventilation complications significantly impact the duration of ICU stays [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eChildhood trauma incidence is intricately linked with economic, cultural, behavioural, and living conditions [\u003cspan additionalcitationids=\"CR44\" citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. Prior research has exhibited distinct geographic and demographic patterns in childhood trauma incidence. Our study also discerned variances in injury types and causes among urban, suburban-rural fringe, and rural children, with a lower incidence in urban and suburban-rural fringe areas than in rural locales. Despite China's rapid economic progress, which has narrowed the urban-rural gap, trauma incidence remains disproportionately high in rural areas. Prolonged transportation times to urban medical facilities and less advanced emergency care in rural regions contribute to this discrepancy. In rural areas, traffic restrictions can lead to prolonged transit times for children needing medical attention in urban centres, thereby delaying access to optimal intervention periods. Moreover, the relative inadequacy of local emergency response facilities and technological capabilities further contributes to this disparity. Another report highlights that left-behind children (those residing in rural China while their parents work in cities, typically cared for by extended family members such as grandparents or other close relatives) face a significantly higher risk of injury than their urban counterparts. [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThis study, confined to a single-centre retrospective summary over nearly a decade, inherently limits its scope in comprehensively depicting the characteristics of trauma. Expanding to a nationwide, multicentre, prospective investigation encompassing diverse geographic regions would afford a broader perspective, enabling a deeper understanding of the current state of trauma in China. Such an endeavour would not only provide a more nuanced picture of trauma epidemiology but also illuminate the effectiveness of educational campaigns, policy improvements, and other preventive measures in mitigating the burden of trauma across the country.\u003c/p\u003e \u003cp\u003ePaediatric trauma constitutes a major public health concern, representing a substantial proportion of unintentional injuries and exhibiting an alarming upward trend in recent years [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. Traffic injuries stand as the paramount cause of paediatric trauma, underscoring the ongoing significance of appropriate utilisation of child restraint systems and protective equipment in prevention efforts. The heightened vulnerability of children under 6 years old and those residing in rural areas, with correspondingly higher injury rates, highlights the pressing need for targeted preventive strategies and public policies tailored to these high-risk demographics. A more thorough comprehension of the characteristics of paediatric trauma can facilitate enhanced public awareness campaigns and educational initiatives, leading to more efficacious prevention measures. The literature has documented that the establishment of trauma systems can reduce mortality rates by 15% [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], emphasising the imperative to strengthen rural healthcare systems and capabilities. Efforts must be directed toward enhancing medical institutions' capacity to provide advanced care for injured children and ensuring efficient patient transfer, collaboratively working to mitigate the multifaceted physiological and psychological impacts that trauma inflicts upon these young patients.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn this study, we found that traffic injuries were the paramount cause of paediatric trauma, followed closely by falls. Children under the age of 6 years were most commonly affected by trauma incidents, with boys experiencing a higher incidence rate. Moreover, rural regions showed a heightened occurrence of paediatric trauma compared to urban areas. Traumatic injuries primarily involved head trauma and multiple complex injuries, with non-working days and the afternoon hours between 12 PM and 6 PM marking the peak periods for such incidents.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eICU, intensive care unit\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate: This study adhered to the principles of the Declaration of Helsinki and was approved by the ethics committee of the children\u0026apos;s hospital affiliated with Zhejiang University School of Medicine (Hangzhou, China; approval number: 2024-IRB-0127-P-01).\u003c/p\u003e\n\u003cp\u003eConsent for publication:\u0026nbsp;Given this\u0026nbsp;study\u0026rsquo;s\u0026nbsp;retrospective nature and minimal risk, written informed consent was waived.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials:\u0026nbsp;The data can be found online at https://doi: 10.17632/7mvzk58ctj.2\u003c/p\u003e\n\u003cp\u003eCompeting interests:\u0026nbsp;All authors are Editorial Board members of\u0026nbsp;the\u0026nbsp;World Journal of Emergency Surgery and were excluded from the peer review process for this article.\u003c/p\u003e\n\u003cp\u003eFunding:\u0026nbsp;This work was supported by the grants from the Key Program of The Independent Design Project of National Clinical Research Center for Child Health. [No. G20B0009 (Linhua Tan)].\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions:\u0026nbsp;All collaborators participated in drafting the manuscript,\u0026nbsp;and all individuals agreed\u0026nbsp;to\u0026nbsp;its submission. The corresponding author attests that all listed\u0026nbsp;collaborators\u0026nbsp;meet\u0026nbsp;the\u0026nbsp;required criteria and that no others have been omitted.\u003c/p\u003e\n\u003cp\u003eAcknowledgements: We would like to thank Editage (www.editage.cn) for English language editing.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGuice KS, Cassidy LD, Oldham KT. Traumatic injury and children: a national assessment. J Trauma. 2007; 63: S68-S80; discussion S81-86 \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/TA.0b013e31815acbb6\u003c/span\u003e\u003cspan address=\"10.1097/TA.0b013e31815acbb6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKyu HH, Pinho C, Wagner JA, et al. Global and National Burden of Diseases and Injuries Among Children and Adolescents Between 1990 and 2013: Findings From the Global Burden of Disease 2013 Study. 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J Trauma. 2006;60:371\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/01.ta.0000197916.99629.eb\u003c/span\u003e\u003cspan address=\"10.1097/01.ta.0000197916.99629.eb\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. discussion 378.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-emergency-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"emmd","sideBox":"Learn more about [BMC Emergency Medicine](http://bmcemergmed.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/emmd","title":"BMC Emergency Medicine","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Paediatrics, trauma, intensive care, injury patterns, risk factors","lastPublishedDoi":"10.21203/rs.3.rs-4713267/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4713267/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003ePaediatric trauma is a pivotal factor contributing to paediatric mortality, with traffic injuries and falls being commonly reported as leading causes of significant injuries among children. Comprehensive investigations from multiple perspectives, including geographical considerations, are crucial to develop more effective strategies for preventing such injuries and thereby reducing the burden of paediatric trauma.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis study involved a retrospective analysis of clinical data from paediatric patients admitted to our hospital's intensive care unit (ICU) due to trauma over a 10-year period. Comprehensive analyses were conducted to elucidate trends, demographics, injury patterns, and risk factors associated with these admissions.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThis retrospective study included 951 paediatric patients (mean age: 4.79\u0026thinsp;\u0026plusmn;\u0026thinsp;3.24 years; mean weight: 18.45\u0026thinsp;\u0026plusmn;\u0026thinsp;9.02 kg; median time to ICU admission post-injury: 10.86\u0026thinsp;\u0026plusmn;\u0026thinsp;14.95 hours). Of these patients, 422 (44.4%) underwent emergency surgery and 466 (49%) required mechanical ventilation support, with a mean duration of 70.19\u0026thinsp;\u0026plusmn;\u0026thinsp;146.62 hours. The mean duration of ICU stay was 6.24\u0026thinsp;\u0026plusmn;\u0026thinsp;8.01 days and overall mean hospital stay was 16.08\u0026thinsp;\u0026plusmn;\u0026thinsp;15.56 days. The predominant cause of unintentional injury was traffic accidents (47.9%), followed by falls (42.5%) and burns/scalds (5.3%). Most incidents involved children aged 0\u0026ndash;6 years (70.7%), with males comprising 60.0% of cases. Injury incidents predominantly occurred between 12 PM and 6 PM (44.5%) and on non-workdays (37.6%). The most common sites of injury were roadsides (49.0%) and rural areas (64.35%). Single-site injuries (58.78%) were more prevalent than multiple-site injuries (41.22%), and head injuries were the most common among single-site injuries (81.57%). At ICU admission, the mean injury severity score was 18.49\u0026thinsp;\u0026plusmn;\u0026thinsp;8.86. Following active intervention, 871 patients (91.59%) showed improvement, whereas 80 (8.41%) succumbed to their injuries.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eTraffic injuries remain the primary cause of paediatric trauma, underscoring the ongoing importance of appropriate use of child restraint systems and protective gear as fundamental preventive measures. The elevated incidence of injuries among children under 6 years old and those residing in rural areas highlights the need for targeted preventive strategies, necessitating tailored interventions and public policy formulations that specifically address these high-risk populations.\u003c/p\u003e","manuscriptTitle":"Epidemiological Analysis of Paediatric Trauma in Intensive Care: A 10-Year Retrospective Study from 2009 to 2018","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-06 17:37:20","doi":"10.21203/rs.3.rs-4713267/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorAssigned","content":"","date":"2024-07-12T05:04:33+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-07-12T05:03:37+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Emergency Medicine","date":"2024-07-09T15:42:41+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-emergency-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"emmd","sideBox":"Learn more about [BMC Emergency Medicine](http://bmcemergmed.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/emmd","title":"BMC Emergency Medicine","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"063009b9-ca6b-4223-9d0d-5492be81295b","owner":[],"postedDate":"August 6th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-08-06T17:37:20+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-06 17:37:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4713267","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4713267","identity":"rs-4713267","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}