Chiaki Toida: Department of Disaster Medical Management, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. ORCID
Takashi Muguruma: Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minami-ku, Yokohama 232-0024, Japan.
Masayasu Gakumazawa: Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minami-ku, Yokohama 232-0024, Japan.
Mafumi Shinohara: Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minami-ku, Yokohama 232-0024, Japan.
Takeru Abe: Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minami-ku, Yokohama 232-0024, Japan.
Ichiro Takeuchi: Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minami-ku, Yokohama 232-0024, Japan.
Naoto Morimura: Department of Disaster Medical Management, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Injury is a major cause of worldwide child mortality. This retrospective nationwide study aimed to evaluate the characteristics of paediatric injured patients in Japan and their in-hospital mortality trends from 2009 to 2018. Injured patients aged <17 years were enrolled. Data were extracted from the Japan Trauma Data Bank. In the Cochran-Armitage test, in-hospital mortality significantly decreased during the study period ( < 0.001), except among patients <1 year old, and yearly reductions were observed among those with an Injury Severity Score ≥16 and survival rate ≥50% ( < 0.001). In regression analyses, patients who underwent urgent blood transfusion within 24 h after hospital admission (odds ratio (OR) = 3.24, 95% confidence interval (CI) = 2.38-4.41) had a higher in-hospital mortality risk. Higher survival probability as per the Trauma and Injury Severity Score was associated with lower in-hospital mortality (OR = 0.92, 95% CI = 0.91-0.92), a risk which decreased from 2009 to 2018 (OR = 6.16, 95% CI = 2.94-12.88). Based on our results, there is a need for improved injury surveillance systems for establishment of injury prevention strategies along with evaluation of the quality of injury care and outcome measures.
