Sibling count and family employment status shape injury patterns and emergency department resource use in pediatric trauma.

BACKGROUND

Paediatric trauma presentations to emergency departments (EDs) are typically low in severity, yet they constitute a substantial component of ED workload. Although social determinants of health influence paediatric injury risk, the role of family structure in shaping injury patterns and healthcare utilisation remains insufficiently explored.

OBJECTIVE

To examine associations between sibling count, family characteristics, injury patterns, and ED resource utilisation in paediatric trauma.

METHODS

This prospective single-centre observational study included children aged 0–15 years presenting with traumatic injuries between October 2025 and January 2026. Demographic variables, household characteristics (sibling count, parental employment status, caregiver availability), and trauma data were recorded prospectively. Associations between sibling count, injury patterns, and ED resource use were analysed using non-parametric tests and multivariable logistic regression adjusted for age and sex.

RESULTS

Among 408 patients (median age 8 years; 62.3% male), overall injury severity was low (median ISS 2) and not associated with sibling count. Higher sibling counts were independently associated with extremity fractures or dislocations (adjusted OR 1.32 per additional sibling, 95% CI 1.10–1.57), and children with ≥ 3 siblings had higher odds of extremity fractures (adjusted OR 2.76). Head injuries were more frequent among children with fewer siblings. Higher sibling counts were also associated with increased specialist consultation requirements.

CONCLUSIONS

Sibling count was associated with injury patterns and selected indicators of ED resource utilisation but not with overall trauma severity. Household context may therefore influence exposure patterns and care pathways in low-acuity paediatric trauma.