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Table 2 Epidemiological studies from the UK – childhood injuries

From: A review of injury epidemiology in the UK and Europe: some methodological considerations in constructing rates

Author and date

Type of study/data source

Population

(denominator)/size

Level of severity

Epidemiological observation

Major findings

Epidemiological shortcomings

Walsh et al., 1996 [50]

descriptive (prospective) study/Coroner's files; Hospital data

children

(0–16 y)/54400

Newcastle upon Tyne, England

deaths, hospitalization and A&E

proportions, rates by severity (ISS), type, cause; correlation A&E rates and Townsend score

1990 6 deaths: 904 admissions: 11682 A&E

(1660/21490 per 100,000 admission/attendance rate); some associations of hospitalisations and A&E with deprivation

1 year study and one geographical region.

Walsh & Jarvis, 1992 [55]

descriptive (retrospective) study/Office for Population Censuses Surveys; Northern Regional Health Authority

sample children

(0–16 y)/153000

Northern Region England

deaths, hospitalization

proportions by type, cause; rates by severity (ISS), age, ward; correlation of rates by census ward, severity

1980–1986 Relationship of injury admission rates, deaths and severity with deprivation, e.g. relative rate of deprived vs. affluent areas 2.4 (all injuries); 3.6 (severe injuries)

Highlights of the value of ISS methodology in epidemiological analysis

96.4% of the hospitals admissions identified.

Armstrong & Robson, 1992 [47]

descriptive study/Liverpool Coroner's Office data

children (0–16 y)

Liverpool, England

deaths

proportions by cause, circumstances

Highlights areas of prevention: 60% pedestrian RTC (1978–1987) – half pedestrians struck by vehicles

No population based rates; data on deaths only; one region

Hippisley-Cox

et al., 2002 [56]

cross sectional survey/Trent NHS regional admissions database

children (0–14 y)

Trent Region, England

hospitalization

proportions by cause, age; rates by age, severity and deprivation; rate ratios for hospitals admissions

1992–1997 socioeconomic gradients (particularly children under 5 y); adjusted rate ratio (fifth highest and lowest category by Townsend scores): 3.65 pedestrian; 3.49 burns & scalds

Data on severity based on health services use; one geographical region only

Laing & Logan, 1999 [53]

descriptive study/A&E

King's College, St Thomas's, Guy's hospitals registries

children (0–14 y)

South-East London, England

A&E

proportions and rates by age, gender, severity; correlation of Townsend score with A&E rates

1992/1993 13820/100,000 annual attendance rate; socioeconomic gradients (even) within a disadvantaged population: a significant correlation between Townsend score and A&E attendance rate (p < 0.001)

1 year study; 4 arbitrary categories of injury severity; codification – Home &Leisure Accident Surveillance

Edwards et al., 2008 [51]

descriptive study/Hospital Episodes Statistics

children (0–15 y)

England

hospitalization

rates and proportions by cause, rate ratio by socio-economic classes, location, index of multiple deprivation, regression (injury rates- census variables)

1999–2004 1340/100,000 all injury rates 15.8/100,000 serious injury rate; falls account for 36% and 41% of all/serious admissions; socio-economic gradients for serious injuries, e.g. RR = 4.1 pedestrian i and RR = 3.0 cyclists most vs. least deprived areas

Serious injury defined by six ICD groups (S72.0, S06.1–.9, S14, S22.4, T71, T68)

Avery et al., 1990 [40]

descriptive study/Office for Population Censuses Surveys

children (0–14 y)

England and Wales

deaths

rates by geographical areas, trends and correlation of deprivation with deaths rates

1975/1979 12.05/100,000; 1980/1984 10.33/100,000 geographical variations (higher urban vs. rural areas, NW vs. SE England); 1980–1984 socioeconomic gradients r = 0.56 for accidental deaths rate

Data on deaths only