Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 1;38(7):e1342-e1347.
doi: 10.1097/PEC.0000000000002752. Epub 2022 Jun 8.

Pediatric Fracture Epidemiology and US Emergency Department Resource Utilization

Caitlin Farrell  1 , Megan Hannon, Michael C Monuteaux  1 , Rebekah Mannix  1 , Lois K Lee  1
Affiliations

Pediatric Fracture Epidemiology and US Emergency Department Resource Utilization

Caitlin Farrell et al. Pediatr Emerg Care. .

Abstract

Objective: Fractures are common childhood injuries that result in emergency department (ED) visits. National trends in pediatric fracture epidemiology and resource utilization are not well described. Our objective is to analyze national trends in pediatric fracture epidemiology, ED disposition, and ED resource utilization from 2010 to 2015.

Methods: This is an epidemiological study of fracture care in US EDs from 2010 to 2015 for children 0 to 18 years old using the Nationwide Emergency Department Sample. We calculated frequencies and national rates using weighted analyses and census data. We used the test for linear trend to analyze incidence, hospital admission, transfer, and procedural sedation over time. Multivariate logistic regression analyses identified encounter- and hospital-level predictors of transfer, admission, operative care, and use of procedural sedation.

Results: During the study period, from 2010 to 2015, a total of 5,398,827 children received ED care for fractures. The pediatric fracture rate was 11.5 ED visits/1000 persons (95% confidence interval [CI], 10.6-12.5) and decreased over time. The admission rate for pediatric fracture patients was 5% and stable over time. The transfer rate increased from 3.3 to 4.1/100 fracture visits (linear trend: odds ratio, 1.06; 95% CI, 1.03-1.09). Utilization of procedural sedation increased from 1.5% to 2.9% of fracture visits (linear trend: odds ratio, 1.17; 95% CI, 1.09-1.25). Predictors associated with disposition and resource utilization include patient age, fracture location, insurance type, hospital type, and region.

Conclusions: The national incidence rate of pediatric fractures decreased slightly. Emergency department resource utilization increased over time. With high national volume, understanding pediatric fracture epidemiology and resource utilization is important to the health care system.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

References

    1. Landin LA. Epidemiology of children's fractures. J Pediatr Orthop Part B . 1997;6:79–83.
    1. Naranje SM, Erali RA, Warner WC, et al. Epidemiology of pediatric fractures presenting to emergency departments in the United States. J Pediatr Orthop . 2016;36:e45–e48.
    1. Nakaniida A, Sakuraba K, Hurwitz EL. Pediatric orthopaedic injuries requiring hospitalization. J Orthop Trauma . 2014;28:167–172.
    1. Randsborg PH, Gulbrandsen P, Benth JŠ, et al. Fractures in children: epidemiology and activity-specific fracture rates. J Bone Jt Surg Ser A . 2013;95.
    1. Kim SH, Szabo RM, Marder RA. Epidemiology of humerus fractures in the United States: Nationwide Emergency Department Sample, 2008. Arthritis Care Res . 2012;64:407–414.

LinkOut - more resources