IN-HOSPITAL TREATED PEDIATRIC INJURIES ARE INCREASING IN FINLAND - A POPULATION BASED STUDY BETWEEN 1997 AND 2006

Background and Aims: Injuries are an important public health problem as well as the leading cause of death and disability among children. Our aim was to longitudinally explore the incidence of in-hospital treated traumas, their operative treatment and related mortality among pediatric patients in Finland. Methods: The National Hospital Discharge Register and the Official Cause-of-Death Statistics data of in-hospital treated pediatric trauma patients between 1997 and 2006 in Finland were evaluated for hospitalizations, treatment modality and mortality. Results: Fractures (69%) and head injuries (28%) were the most common in-hospital treated traumas (477/100 000 persons/year). These were followed by injuries of intra-abdominal (1.4%), thoracic (1.2%) and urological organs (0.6%). Head traumas constituted 67% of injury-related deaths. During the ten-year follow-up period, the annual incidence (per 100 000 persons) of head injuries decreased by 13.6% (152 in 1997 vs. 131 in 2006, p < 0.0001) mainly contributing to a 30% decrease in overall injury-related mortality incidence (from 5.7 in 1997 to 4.0 in 2006, p = 0.0519). The overall trauma incidence, and incidence of fractures and abdominal injuries significantly increased by 5.0% (p < 0.0001), 13.5% (p < 0.0001) and 37% (p < 0.05), respectively, while the incidence of thoracic and urological injuries remained unchanged. Up to 15% of spleen injuries lead to splenectomy. Conclusions: Although overall and head trauma-related mortality is decreasing, the increasing incidence of fractures and abdominal injuries has amplified the overall incidence of severe injuries among children in Finland. A significant number of unnecessary splenectomies are still performed among children.