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. 2025 Jun 11:13:1606347.
doi: 10.3389/fpubh.2025.1606347. eCollection 2025.

Characteristics and trends of unintentional injuries among children and adolescents in Kunshan, China: a hospital-based retrospective study, 2018-2023

Li Shen #  1   2 , Yafang Hua #  3 , Chunfang Gu  3 , Rong Tao  4 , Yuwei Zhang  3 , Bin Huang  5 , Mingqing Yuan  6 , Weibing Wang  7 , Jian Huang  8 , Zhiping Li  1   8
Affiliations

Characteristics and trends of unintentional injuries among children and adolescents in Kunshan, China: a hospital-based retrospective study, 2018-2023

Li Shen et al. Front Public Health. .

Abstract

Objective: This study aimed to characterize the epidemiological trends and mechanisms of pediatric unintentional injuries in Kunshan, China (2018-2023) and to develop time series models to predict future trends.

Methods: A retrospective analysis was conducted on 77,379 pediatric unintentional injury cases, stratified by age, gender, and injury categories. Subgroup analyses targeted children under 5 years. To adjust for pandemic-related disruptions, separate comparisons between 2018 and 2023 were performed. Time series analysis employed an ARIMA model, with model selection based on information criteria and residual diagnostics, and a non-COVID-19 dataset (2018, 2019, and 2023) for forecasting future trends.

Results: Males constituted 62.76% of cases, with a mean age of 5.37 ± 3.55 years. The primary age groups were 3-6 years and 6-12 years, which accounted for 60% of the total population. Falls (21.36%) and transport injuries (4.00%) predominated, with limbs being the most injured body part (59.08%). Contusions/abrasions (41.54%) and sprains/strains (31.21%) were common. Subgroup analysis was performed in children under 5 years old, with 22,110 being males (57.5%) and 16,291 being females (42.5%). Among this group, falls and burns were identified as the most frequent incidents. Unintentional injury cases decreased significantly during COVID-19 (2020-2022). The refined ARIMA(1,1,2) (0,1,1)[12] model, excluding pandemic effects, achieved a mean absolute percentage error of 6.46% while revealing seasonal patterns and predicting a slight downward trend for 2024-2026.

Conclusion: Pediatric unintentional injuries in Kunshan exhibited gender and age-specific patterns, with COVID-19 altering injury profiles. The ARIMA model can capture the seasonal patterns of unintentional injuries to a certain extent, facilitating public health planning and intervention strategies.

Keywords: ARIMA model; children and adolescents; epidemiological trends; time series analysis; unintentional injury.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Frequency of unintentional injuries in six age groups. (a) The distribution of unintentional injuries in different age groups and genders. (b) The distribution of unintentional injuries across age groups and genders in 2018 and 2023.
Figure 2
Figure 2
Characteristics of unintentional injuries. (a) The top 7 frequencies of injuries in different age groups. (b) The distribution of unintentional injuries in different years. (c) The distribution of unintentional injuries in different months. (d) The top 7 frequencies of injuries in different genders. (e) The top 6 frequencies of injury nature. (f) The injury position. (g) The distribution of unintentional injuries in children under five in different years. (h) The top 7 frequency of injuries in children under five. (i) The top 6 frequencies of injury nature in children under five.
Figure 3
Figure 3
Temporal Trends of Childhood Unintentional Injuries in Kunshan, 2018–2023.
Figure 4
Figure 4
Seasonal Patterns in Childhood Unintentional Injuries in Kunshan.
Figure 5
Figure 5
Autocorrelation and partial autocorrelation functions of original and first-order differenced time series.
Figure 6
Figure 6
Autocorrelation and partial autocorrelation functions of seasonally and simultaneously differenced time series.
Figure 7
Figure 7
Forecasting Pediatric Unintentional Injuries in Kunshan, 2024–2026.
See this image and copyright information in PMC

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