Sequelae after unintentional injuries to children: An exploratory study

Abstract

Goal - To determine the frequency and categories of sequelae related to accidental injuries (of all types) in childhood, a prospective follow up study was conducted on a geographically defined population near Paris, France. Methods - The study concerned all child residents of one health care district, aged under 15 years, and hospitalised in the two public hospitals of the district, and/or transported by mobile emergency units, after an accident, during a one year period (in 1981-82; n = 785). Initial severity was scored using the injury severity score (ISS). Sequelae were defined as established impairments (leading or not to disabilities), identified by physicians, reporting their clinical diagnosis or complaints by the child and/or the family. Results - After a follow up period of 3.6-29.2 months after the accident, six children died and 78 (10%) were lost to follow up. Among the 701 others, 73 (10.4%) presented 80 sequelae, major (limiting daily activities) in 44 children (6.3%), with no gender difference. These increased significantly with age. The main causes of major sequelae were eye injuries and sports related injuries to the limbs. ISS did not correlate well with sequelae, but the maximum abbreviated injury scale appeared to be a better predictor of long term functional prognosis. Conclusion - Prospective follow up and population based studies are still needed, especially on children's injuries initially perceived as benign, such as most of the sports related injuries in our study.