Characteristic of school injuries in Asia: a cross-national, multi-center observational study

Chen SH 1 , Lee MC 1 , Wang PY 2 , Ma MH 1 , Do Shin S 3 , Sun JT 2 Show all authors , Jamaluddin SF 4 , Tanaka H 5 , Son DN 6 , Hong KJ 7 , Tseng WC 8 , Chiang WC 9 , PATOS Clinical Research Network

Affiliations 

  • 1 Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan
  • 2 Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan
  • 3 Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, Korea
  • 4 Faculty of Medicine, Universiti Teknologi MARA, Shah Alam, Malaysia
  • 5 Graduate School of Emergency Medical Service System, Kokushikan University, Tokyo, Japan
  • 6 Center for Critical Care Medicine, Bach Mai Hospital, Hanoi, Vietnam
  • 7 Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, South Korea
  • 8 Department of Pediatrics, National Taiwan University Children's Hospital, Taipei City, Taiwan. littlecardiologist@gmail.com
  • 9 Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan. drchiang.tw@gmail.com
Pediatr Res, 2023 Nov 07.
PMID: 37935885 DOI: 10.1038/s41390-023-02884-9

Abstract

BACKGROUND: To prevent school injuries, thorough epidemiological data is an essential foundation. We aimed to investigate the characteristics of school injuries in Asia and explore risk factors for major trauma.

METHODS: This retrospective study was conducted in the participating centers of the Pan-Asian Trauma Outcome Study from October 2015 to December 2020. Subjects who reported "school" as the site of injury were included. Major trauma was defined as an Injury Severity Score (ISS) value of ≥16.

RESULTS: In total, 1305 injury cases (1.0% of 127,715 events) occurred at schools. Among these, 68.2% were children. Unintentional injuries were the leading cause and intentional injuries comprised 7.5% of the cohort. Major trauma accounted for 7.1% of those with documented ISS values. Multivariable regression revealed associations between major trauma and factors, including age, intention of injury (self-harm), type of injury (traffic injuries, falls), and body part injured (head, thorax, and abdomen). Twenty-two (1.7%) died, with six deaths related to self-harm. Females represented 28.4% of injuries but accounted for 40.9% of all deaths.

CONCLUSIONS: In Asia, injuries at schools affect a significant number of children. Although the incidence of injuries was higher in males, self-inflicted injuries and mortality cases were relatively higher in females.

IMPACT: Epidemiological data and risk factors for major trauma resulting from school injuries in Asia are lacking. This study identified significant risk factors for major trauma occurring at schools, including age, intention of injury (self-harm), injury type (traffic injuries, falls), and body part injured (head, thoracic, and abdominal injuries). Although the incidence of injuries was higher in males, the incidence of self-harm injuries and mortality rates were higher in females. The results of this would make a significant contribution to the development of prevention strategies and relative policies concerning school injuries.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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