Injury across the lifespan: Comparing pediatric and adult injury patterns in the home and the community.

Abstract

Comparative data describing patterns of injury occurring in the home and in the community across ages are limited yet may guide family- and community-based interventions. We sought to assess potential differences in patient characteristics, injury mechanisms, and outcomes, as well as between injuries occurring at home compared to those in the community across all ages. Patients from a level I pediatric and level I adult trauma center who resided and were injured in a single metropolitan county from 2016 - 2022 were included. Demographics, mechanism of injury, and outcome measures were compared. The top three injury mechanisms (falls, motor vehicle crash (MVC), and firearm) were included for analysis. Patients' residential address and injury location were geocoded. Injuries that occurred at home were those <0.1miles from the patient's residence. Statistical analysis included Kruskal-Wallis and Wilcoxon rank-sum tests, and Spearman correlation to evaluate the relationship between age and distances (straight line and driving) from residence to injury location. There were 1235 and 7680 patients in the pediatric and adult registries, respectively. Male patients accounted for the majority of those <65 years. Trends emerging in the 10-14-year-old age group continued through the 25-44-year-old group; these include increased firearm and MVC injury, injury among Black individuals, assaultive injuries, worse injury severity, and injury in the community. Falls were most prevalent among those aged <10 and >44 years. White children and adults were more likely to be injured at home; other races were disproportionately injured in the community. Injury in the community was more likely to result in higher injury severity in both adults and children. Mechanism-specific injury trends emerging in children and youth that occur in the community continue into adulthood. Community-based intervention strategies are needed. Injuries at home, however, occur in a bimodal age-related pattern and may inform interventions and family-based education initiatives.