The impact of pediatric trauma in the Amish community

• Published in: The Journal of pediatrics 2006-03, Vol.148 (3), p.359-365
• Main Authors: Vitale, Melissa A., Rzucidlo, Susan, Shaffer, Michele L., Ceneviva, Gary D., Thomas, Neal J.
• Format: Article
• Language: English
• Subjects: Accidental Falls - statistics & numerical data; Accidents, Traffic - statistics & numerical data; Adolescent; Agriculture; Animals; Biological and medical sciences; Child; Child, Preschool; Critical Care - utilization; Diagnostic Imaging - utilization; Ethnic Groups; Female; General aspects; Hospital Charges - statistics & numerical data; Humans; Infant; Length of Stay - statistics & numerical data; Male; Medical sciences; Patient Admission - statistics & numerical data; Pennsylvania - epidemiology; Periodicity; Respiration, Artificial - utilization; Retrospective Studies; Severity of Illness Index; Surgical Procedures, Operative - statistics & numerical data; Transportation; Wounds and Injuries - epidemiology
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2005.10.036

To describe the epidemiology of trauma in Amish children and to determine differences in treatment and outcome related to injury mechanism. In this retrospective review, data were collected on all Amish children with trauma requiring hospital admission. Demographic, interventional, and outcome data were collected. Categorical outcomes were compared by using chi-square, logistic regression, or Fisher exact test; continuous outcomes were compared with analysis of variance. A total of 135 trauma admissions were studied. There was a significant difference of proportion of injury by month ( P < .01). The most common mechanisms of injury were falls (39%), buggy versus motor vehicle accidents (MVA; 16%), and animal injuries (14%). A total of 41% of patients required operative procedures, and 50% of subjects required intensive care. Animal injuries and buggy versus MVA were significantly associated with a requirement for surgery, increased length of stay, and increased severity (all P < .01). The overall mortality rate was 3%. There were significant associations between mechanism of injury and outcome scores ( P < .05) and hospital charges ( P < .05). The spectrum of traumatic injuries is unique among Amish children. These injuries contribute significantly to morbidity and mortality and impose a large monetary burden on the Amish community. Education may decrease the incidence of these events.