Abstract

Objective: Pediatric unintentional injuries are a major public health concern, as most are preventable. This study aimed to assess emergency department cases by etiology, demographics, seasonal distribution, and outcomes, to define the regional profile and guide prevention.

Material and Methods: This retrospective study included 2524 children aged 0–18 years admitted with unintentional injuries between January 2021 and June 2024. Cases were classified as trauma, poisoning/aspiration, environmental injuries, or other causes.

Results: Of the cases, 1454 (57.6%) were male, median age 47 months. Poisoning/aspiration was most common (n=1153; 45.6%), followed by trauma (n=840; 33.2%), environmental injuries (n=473; 18.7%), and others (n=62; 2.4%). Poisonings predominated in 0–5 years, while trauma was more frequent in adolescents. Leading poisoning causes were drugs (n=516; 20.4%) and corrosives (n=441; 17.5%). Carbon monoxide poisoning was notable among environmental injuries (n=267; 10.6%). Most patients were discharged (80.6%), while 14.5% were hospitalized, 3.7% required intensive care, and 5.5% underwent surgery. Mortality and sequelae were each 0.3%. Seasonal variation was evident: poisonings in spring–summer, trauma in summer–autumn, and carbon monoxide in winter.

Conclusion: Poisonings were the leading cause in early childhood, while trauma predominated in adolescents. Preventive strategies, including parental education, household safety, and region-specific policies, are essential to reduce morbidity and mortality.

Keywords: Accident, adolescent, child, poisoning, wounds and injuries

References

  1. Jullien S. Prevention of unintentional injuries in children under five years. BMC Pediatr. 2021;21(Suppl 1):311.https://doi.org/10.1186/s12887-021-02517-2
  2. World Health Organization. Injuries and violence: the facts. Geneva: WHO; 2014. Available from: Chrome extension://efaidnbmnnnibpcajpcglclefindmkaj/https://iris.who.int/bitstream/handle/10665/149798/9789241508018_eng.pdf (Accessed: August 26, 2025).
  3. World Health Organization. Injuries and violence: the facts. Geneva: WHO; 2014. Available from: http://whqlibdoc.who.int/ publications/2008/9789241563574 _ eng.pdf (accessed 28.08.2025).
  4. World Health Organization. World Report on Child Injury Prevention: Summary. Geneva: WHO; 2008.
  5. Balan B, Lingam L. Unintentional injuries among children in resource poor settings: where do the fingers point? Archives of disease in childhood. 2012;97(1):35-8. https://doi.org/10.1136/archdischild-2011-300589
  6. Hagan JF, Shaw JS, Duncan PM. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2017. https://doi.org/10.1542/9781610020237
  7. Türkiye İstatistik Kurumu (TÜİK). Ulusal Eğitim İstatistikleri 2023. Bülten No: 53444. Ankara: TÜİK; 2024.
  8. Perrin EM, Skinner AC, Sanders LM, et al. The injury prevention program to reduce early childhood injuries: a cluster randomized trial. Pediatrics. 2024;153(5):e2023062966. https://doi.org/10.1542/peds.2023-062966
  9. T.C. Sanayi ve Teknoloji Bakanlığı, Kalkınma Ajansları Genel Müdürlüğü. İller ve Bölgeler Sosyoekonomik Gelişmişlik Sıralaması Araştırması (SEGE-2017). Ankara: Sanayi ve Teknoloji Bakanlığı; 2017. [07.06.2025]. Available from: https://www.sanayi.gov.tr/merkez-birimi/b94224510b7b/sege/il-sege-raporlari.
  10. Varnaccia G, Saß AC, Rommel A. Unintentional injuries among children and adolescents in Germany. Data sources and results. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014;57(6):613-20. https://doi.org/10.1007/s00103-014-1962-z
  11. Wang Z, Chen H, Yu T, et al. Status of injuries as a public health burden among children and adolescents in China: A systematic review and meta-analysis. Medicine (Baltimore). 2019;98(45): e17671. https://doi.org/10.1097/MD.0000000000017671
  12. Giashuddin SM, Rahman A, Rahman F, et al. Socioeconomic inequality in child injury in Bangladesh-implication for developing countries. Int J Equity Health. 2009;8:1-8. https://doi.org/10.1186/1475-9276-8-7
  13. Kanchan T, Menezes RG, Monteiro FN. Fatal unintentional injuries among young children-a hospital based retrospective analysis. J Forensic Leg Med. 2009;16(6):307-11. https://doi.org/10.1016/j.jflm.2008.12.017
  14. Gummin DD, Mowry JB, Spyker DA, et al. 2017 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 35th Annual Report. Clin Toxicol (Phila). 2018;56(12):1213-415. https://doi.org/10.1080/15563650.2018.1533727
  15. Gummin DD, Mowry JB, Beuhler MC, et al. 2022 Annual Report of the National Poison Data System(®) (NPDS) from America’s Poison Centers(®): 40th Annual Report. Clin Toxicol (Phila). 2023;61(10):717-939. https://doi.org/10.1080/15563650.2018.1533727
  16. Sawayama Y, Yamaji K, Kohsaka S, et al. Variation in in-hospital mortality and its association with percutaneous coronary intervention-related bleeding complications: A report from nationwide registry in Japan. PLoS One. 2021;16(12): e0261371. https://doi.org/10.1371/journal.pone.0261371
  17. Jacobs JP, Mavroudis C, Jacobs ML, et al. What is operative mortality? Defining death in a surgical registry database: a report of the STS Congenital Database Taskforce and the Joint EACTS-STS Congenital Database Committee. Ann Thorac Surg. 2006;81(5):1937-41. https://doi.org/10.1016/j.athoracsur.2005.11.063
  18. Haagsma JA, Graetz N, Bolliger I, et al. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev. 2016;22(1):3-18. https://doi.org/10.1136/injuryprev-2015-041616
  19. Hashikawa AN, Newton MF, Cunningham RM, et al. Unintentional injuries in child care centers in the United States: a systematic review. J Child Health Care. 2015;19(1):93-105. https://doi.org/10.1177/1367493513501020
  20. Taplak AŞ, Tubaş F, Polat S. A retrospective records-based cohort of 1,082 pediatric forensic cases presenting to the emergency department. J Emerg Nurs. 2020;46(3):373-83. https://doi.org/10.1016/j.jen.2020.02.009
  21. Uwumiro F, Okpujie V, Olaomi OA, et al. Profile of Childhood Poisoning and Its Outcomes in the United States: A One-Year Nationwide Study of Emergency and Inpatient Admissions. Cureus. 2023;15(4): e37452. https://doi.org/10.7759/cureus.37452
  22. Suting E, Bhaskar V, Batra P. Changing epidemiology of poisoning in children: a retrospective study from a tertiary care center in New Delhi, India. Indian J Public Health. 2021;65(4):400-2. https://doi.org/10.4103/ijph.IJPH_234_21
  23. Peden M. World Report on Child Injury Prevention. Geneva: WHO; 2008. https://doi.org/10.1111/j.1651-2227.2008.01162.x
  24. Saikia D, Sharma R, Janardhan KV. Clinical profile of poisoning due to various poisons in children of age 0-12 years. J Family Med Prim Care. 2020;9(5):2291-6. https://doi.org/10.4103/jfmpc.jfmpc_365_20
  25. Nguyen SN, Vu LT, Nguyen HT, et al. Childhood Acute Poisoning at Haiphong Children’s Hospital: A 10-Year Retrospective Study. Int J Pediatr. 2023;2023(1):2130755. https://doi.org/10.1155/2023/2130755
  26. Heji CC, Onu NN, Nduagubam OC, et al. Childhood poisoning: a 10-year experience in a tertiary hospital in Enugu State, Nigeria. Emerg Care J. 2024;20(2). https://doi.org/10.4081/ecj.2024.12351
  27. Andiran N, Sarikayalar F. Pattern of acute poisonings in childhood in Ankara: what has changed in twenty years? Turk J Pediatr. 2004;46(2):147-52.
  28. Boxberger K, Reimers AK. Parental correlates of outdoor play in boys and girls aged 0 to 12 - a systematic review. Int J Environ Res Public Health. 2019;16(2):190. https://doi.org/10.3390/ijerph16020190
  29. Larouche R, Kleinfeld M, Charles Rodriguez U, et al. Determinants of outdoor time in children and youth: a systematic review of longitudinal and intervention studies. Int J Environ Res Public Health. 2023;20(2). https://doi.org/10.3390/ijerph20021328
  30. Litovitz TL, Schmitz BF, Bailey KM. 1989 Annual report of the American Association of Poison Control Centers national data collection system. Am J Emerg Med. 1990;8(5):394-442.https://doi.org/10.1016/0735-6757(90)90234-Q
  31. Schmertmann M, Williamson A, Black D, et al. Risk factors for unintentional poisoning in children aged 1-3 years in NSW Australia: a case-control study. BMC Pediatr. 2013;13:88. Epub 20130524. https://doi.org/10.1186/1471-2431-13-88
  32. Fernandes JP, Hazra D, Jyothirmayi CA, et al. Adolescent trauma: patterns and outcomes. Int J Acad Med. 2021;7(2):126-31.https://doi.org/10.4103/IJAM.IJAM_103_20
  33. Aoki M, Abe T, Saitoh D, et al. Epidemiology, patterns of treatment, and mortality of pediatric trauma patients in Japan. Sci Rep. 2019;9(1):917. https://doi.org/10.1038/s41598-018-37579-3
  34. Newgard CD, Lin A, Olson LM, et al. Evaluation of Emergency Department Pediatric Readiness and Outcomes Among US Trauma Centers. JAMA Pediatr. 2021;175(9):947-56. https://doi.org/10.1001/jamapediatrics.2021.1319
  35. Yilmaz G, Alemdar DK. Evaluation of Pediatric Forensic Cases Admitted to the Emergency Department in Turkey: A Retrospective Analysis. J Forensic Nurs. 2021;17(1): E1-E8. https://doi.org/10.1097/JFN.0000000000000309
  36. Düzova A, Akgül S, Utine GE, et al. The Türkiye-Syria Earthquake: a response from the editors of the Turkish Journal of Pediatrics. Turk J Pediatr. 2023;65(1):1-2. https://doi.org/10.24953/turkjped.2023.E001
  37. Agar A, Sahin A, Gunes O, et al. Seasonal variation in paediatric orthopaedic trauma patients - A single centre experience from Turkey. J Orthop Surg (Hong Kong). 2022;30(1):23094990211068146. https://doi.org/10.1177/23094990211068146
  38. Terrani KF, Bhogadi SK, Hosseinpour H, et al. What Is Going on in Our Schools? Review of Injuries Among School Children Across the United States. J Surg Res. 2024;295:310-7. https://doi.org/10.1016/j.jss.2023.11.019
  39. Gozubuyuk AA, Dag H, Kacar A, et al. Epidemiology, pathophysiology, clinical evaluation, and treatment of carbon monoxide poisoning in child, infant, and fetus. North Clin Istanb. 2017;4(1):100-7. doi: 10.14744/nci.2017.49368.
  40. Can G, Sayılı U, Aksu Sayman Ö, et al. Mapping of carbon monoxide related death risk in Turkey: a ten-year analysis based on news agency records. BMC Public Health. 2019;19(1):9. https://doi.org/10.1186/s12889-018-6342-4

Copyright and license

Copyright © 2026 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Torun Ö, Serin O, Erdem Torun Ş, Çiçek Kanatlı M. Pediatric unintentional injuries in emergency care: A three-year retrospective study from a tertiary care center. Turk J Pediatr Dis. 2026;Early View:1-8. https://doi.org/10.12956/TJPD.2025.1265