Where to start? Injury prevention priority scores in Canadian children

Purpose: Given limited resources, it is essential to determine which Mechanisms of Injury (MOIs)to prioritize for injury prevention policy and research. We developed objective, evidence-based Injury Prevention Priority Scores (IPPSs)for Canadian children across three prevention perspectives: mortality, injury severity, and resource utilization. Methods: We performed a retrospective cohort study of all injuries in Canada in individuals aged 0 to 19 years old from 2009 to 2014. For each MOI, an IPPS was calculated as a balanced measure of frequency and either mortality rate, median ICD-10 derived Injury Severity Score (ICISS), or median cost per hospitalization. Results: Of 87,017 injuries, 83,112 were nonfatal hospitalizations, and 3905 were deaths. Overall mortality rate was 0.04 deaths/injury, median ICISS was 0.994 (IQR 0.75–0.996), and median cost per hospitalization was CAD$3262 (IQR $2118–$5001). The top three mechanisms were falls (IPPS 72), intentional self-harm (IPPS 68), and drowning (IPPS 65)for mortality, falls (IPPS73), drowning (IPPS 61), and suffocation (IPPS 61)for injury severity and falls (IPPS 70), fires (IPPS 65), and intentional self-harm (IPPS 60)for resource utilization. Conclusion: Falls, if prevented, would provide the most benefit to the largest proportion of the Canadian pediatric population and should be targeted for injury prevention. Level of evidence: Level III.