Clinical characteristics and socioeconomic determinants of unintentional childhood injuries: An emergency department perspective.

BACKGROUND: Unintentional childhood injuries (UCIs) are a leading cause of morbidity and mortality among children globally, imposing significant clinical and economic burdens, particularly in low- and middle-income countries. Emergency Departments (EDs) serve not only as the first point of contact for such events but also as the initial entry point for non-fatal UCIs, which represent a hidden and more substantial burden on health services. The primary objective of this study is to comprehensively analyze the clinical and socioeconomic determinants and predictors of unintentional childhood injuries (UCIs) presenting to the emergency department. Based on insights from these empirical data, the study further proposes a multidisciplinary, four-dimensional framework as a conceptual model to enhance systemic prevention and intervention strategies.

METHODS: This is a prospective and cross-sectional study. Data were collected using structured forms and digital medical records, covering demographic, familial, socioeconomic, and injury-related variables. Statistical analyses were performed to examine associations among risk factors, injury mechanisms, clinical outcomes, and mortality predictors.

RESULTS: Falls were the most common cause of UCI (49.8%), followed by traffic accidents (12.4%). Injuries most frequently occurred at home(43.6%), particularly in kitchens and gardens. Male patients constituted 62.7% of the cases. Statistically significant associations were observed between low maternal education, poor economic status, and higher Injury Severity Score (ISS). Multiple trauma(MT) was more common among children aged≥12 years and those with separated parents. Elevatedserum glucose (≥153 mg/dL) and glucose/potassium ratio (≥39.48) were identified as potential clinical markers for assessing mortality risk (p<0.001). MT, abdominal and thoracic trauma, and higher ISS were associated with increased mortality.

CONCLUSION: Early identification of high-risk patients using clinical predictors such as serum glucose may improve treatment outcomes. Additionally, the frequent occurrence of head, upper, and lower extremity injuries in the ED indicates that these regions should be carefully examined for potential injuries. The tendency for thoracic and abdominal injuries to co-occur, as well as the higher prevalence of MT among patients with abdominal trauma-and the predictive value of abdominal injuries for adverse clinical outcomes-underscore the need for thorough evaluation of other systems and differentiated clinical monitoring in children identified with abdominal injury. Multidisciplinary and systematic prevention and treatment strategies that address clinical, socioeconomic, and environmental factors remain essential for reducing both the incidence and severity of such injuries. The multidisciplinary, task force-oriented approach proposed in this study-emphasizing the clear definition of roles-may offer significant improvements in this regard.