Trends in trauma-related mortality among adolescents: A 6 year snapshot from a teaching hospital's post mortem data.

Introduction: The aim is to explore the trends in trauma mortality in children aged 0-18 years can help to co-ordinate resources toward research and programs to reduce the burden.

Methods: This is a retrospective study carried out on adolescents ≤18 years of age autopsied according to the attorney request at Forensic Medicine & Toxicology department of King George's Medical University, Lucknow, India in the period from January 1st, 2009 to December 31st, 2014.

Results: There were 9160 deaths from all causes in children ≤18 years old, 7747 of which were due to trauma related causes, with a female predominance of 1.3:1. The age distribution revealed that 65.8% of deaths occurred in the 10-18 age group. Road traffic accidents (RTA) was the most prevalent cause (3635 deaths - 46.92%), followed by asphyxia (1128 deaths - 14.56%) and sexual assault (649 deaths - 8.37%). Asphyxia/suffocation was the major cause of injury with 31.96% of deaths within group <1 year; asphyxia (28.66%) and transport-related injuries (32.27%) were more predominant in the 1-4 age group; transport-related deaths were frequent in the 5-9 age group (45.14%), 10-14 age group (55.68%) and in the group 15-18 age group (51.69%). Regarding times of death, 61% occurred at the scene, 5.6% during pre-hospital care, 26.2% occurred at the hospital within the first 24 h after admission, and the remaining 7.6% of deaths occurred after 24 h after admission to the hospital. When we analyzed the deaths according to the intent, homicides occurred in 16% of cases. Unintentional injuries occurred in 69% of deaths and self-inflicted injuries were identified in 15% cases.

Conclusions: Findings show that there was a predominance of deaths in children and adolescents males, between 15 and 18 years old, mainly from road traffic accidents. This study highlights the burden of trauma caused mortalities in children, which requires instant action.