INJURY IDENTIFICATION FOR A GEORGIA BIRTH COHORT: RETROSPECTIVE ANALYSIS OF EMERGENCY ROOM VISITS AND HOSPITAL DISCHARGES FOR CHILDREN AGE 0-3 Público

Distelhorst, Kathryn Ann (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/8623hz39w?locale=es
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Abstract

Injury is one of the most under-recognized public health problems facing the Unites States health system. The prevention of child injuries deserves increased attention given the vulnerability and dependency of this age group. This study presents a retrospective cohort analysis of early childhood unintentional injury presenting to an emergency room setting for treatment. The dataset is constructed from deterministic record linkage of emergency room and hospital discharge records for a three-year period (2008-2010) to the 2007 Georgia birth cohort (n=154,025). Records were de-duplicated and linked using a unique identifier, which included sex, date of birth, and portions of first and last names. The analysis dataset included injury records for the first emergency room encounter per child over the three-year period. The data was restricted to children age 0-3. Of 42,539 records for children age 0-3 presenting with an injury diagnosis from 2008-2010, 32,927 (77%) linked to a Georgia Birth Record in 2007. A total of 8,451 children had multiple emergency room discharge records. The risk of unintentional injury requiring emergency room or hospital care was 21.4%. Males had 19% higher risk of injury than did females of the same age (95%CI: 1.17, 1.21, p<0.0001). Open wound of head, neck, and trunk was most common injury category (n=7,122, 21.6%) for this age group. Maternal age at birth was the strongest independent risk factor for childhood unintentional injury before the age of four. Risk of childhood injury decreased with increasing maternal age (CMH=198.6, p<0.0001). After adjusting for offspring sex, maternal educational level, and maternal first birth event, children born to mothers age 15 to 19 were 1.59 times more likely to present with an injury at an emergency room or hospital than children born to mothers age 25 to 29 (95%CI: 1.54, 1.64). This study adds to the growing body of literature employing childhood record linkage and argues for more focused research of childhood injury.

Table of Contents

TABLE OF CONTENTS

BACKGROUND / LITERATURE REVIEW................................................................................. Page 1

METHODS ....................................................................................................................... Page 9

RESULTS......................................................................................................................... Page 15

DISCUSSION.................................................................................................................... Page 18

STRENGTHS AND WEAKNESSES.......................................................................................... Page 25

FUTURE DIRECTIONS......................................................................................................... Page 28

REFERENCES..................................................................................................................... Page 30

TABLES............................................................................................................................. Page 35

APPENDICES...................................................................................................................... Page 43

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