Document Type : Original Article


1 Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran

3 Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran


Background: Trauma, the most common cause of mortality in children and adolescents, imposes high costs on the community. This study aimed to investigate the epidemiology of trauma in children and adolescents and the risk factors associated with death to provide a clinical model of traumas in terms of the type of injury and to adopt effective preventive interventions.
Methods: This cross-sectional study was conducted on 12522 children and adolescents based on the data recorded in the Emergency Medical Services (EMS 115) in 2017. The study population consisted of trauma patients who had contacted EMS 115. Then, demographic and clinical variables were analyzed using the Chi-square test and logistic regression model.
Results: The results showed that 3448 out of the 12522 participants (27.5%) were female, and 9072 (72.5%) were male. The mean age of the injured people was 11.82±5.33 years. The highest and lowest injuries frequencies were accidents (71.8%) and drowning (22%), respectively. Additionally, the highest frequency of death was related to drowning (25.93%). Furthermore, accidents, combats, falls, and drowning significantly correlated with mortality (P<0.001).
Conclusion: Considering the relationship between accidents, combats, falls, drowning, and mortality, it can be concluded that the identification of at risk groups, development of training courses, and adoption of protective measures can help take an effective step toward preventing these types of injuries and declining the frequency of mortality among trauma patients.


  1. Rajput K, Sud A, Rees M, Rutka O. Epidemiology of trauma presentations to a major trauma centre in the North West of England during the COVID-19 level 4 lockdown. European journal of trauma and emergency surgery : official publication of the European Trauma Society. 2021;47(3):631-6.
  2. Costello EJ, Erkanli A, Fairbank JA, Angold A. The prevalence of potentially traumatic events in childhood and adolescence. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies. 20015;15(2):112-99.
  3. Aoki M, Abe T, Saitoh D, Oshima K. Epidemiology, patterns of treatment, and mortality of pediatric trauma patients in japan. Scientific reports.2019;9(1):917.
  4. Durkin M. The epidemiology of developmental disabilities in low‐income countries. Mental retardation and developmental disabilities research reviews.2002;8(3):11-206.
  5. Krug EG, Sharma GK, Lozano R. The global burden of injuries. American journal of public 2000;90(4):523.
  6. Asadi P, Asadi K, Rimaz S, Monsef-Kasmaie V, Zohrevandi B, Mohtasham-Amiri Z. Epidemiology of trauma in children admitted to Poursina Teaching Hospital. Journal of Guilan University of Medical Sciences.2015;23(92):15-9.
  7. Slain KN, Wurtz MA, Rose JA. US children of minority race are less likely to be admitted to the pediatric intensive care unit after traumatic injury, a retrospective analysis of a single pediatric trauma center. Injury epidemiology. 2021;8(1):1-10.
  8. Avraham JB, Bhandari M, Frangos SG, Levine DA, Tunik MG, Dimaggio CJ. Epidemiology of paediatric trauma presenting to US emergency departments. Injury prevention. 2019;25(2):43-136.
  9. Shamohammadi M, Salmanian M, Mohammadi MR, Sadeghi Bahmani D, Holsboer-Trachsler E, Brand S. Prevalence of self-reported trauma in a sample of Iranian children is low and unrelated to parents' education or current employment status. Revista brasileira de psiquiatria 2019;41(3):208-12.
  10. Mehmood A, Agrawal P, Allen KA, Al-Kashmiri A, Al-Busaidi A, Hyder AA. Childhood injuries in Oman: retrospective review of a multicentre trauma registry data. BMJ paediatrics open. 2018;2(1):12-17.
  11. Kord Z, Alimohammadi N, Jafari Mianaei S, Riazi A, Zarasvand B. Clinical Guideline for Nursing Care of Children with Head Trauma (HT): Study Protocol for a Sequential Exploratory Mixed-Method Study. Pediatric health, medicine and therapeutics. 2020;11:269-75
  12. Forouzanfar MH, Sepanlou SG, Shahraz S, BESc PN, Pourmalek F, Lozano R, et al. Evaluating causes of death and morbidity in Iran, global burden of diseases, injuries, and risk factors study 2010. Archives of Iranian medicine. 2014;17(5):304.
  13. Khazaei Z, Khazaei S, Valizadeh R, Mazharmanesh S, Mirmoeini R, Mamdohi S, et al. The epidemiology of injuries and accidents in children under one year of age, during (2009-2016) in Hamadan Province, Iran. International Journal of Pediatrics. 2016;4(7)2213-2220.
  14. Forouzanfar MM, Safari S, Niazazari M, Baratloo A, Hashemi B, Hatamabadi HR, et al. Clinical decision rule to prevent unnecessary chest X‐ray in patients with blunt multiple traumas. Emergency Medicine Australasia. 2014;26(6)6-561.
  15. Younesian S, Mahfoozpour S, Shad EG, Kariman H, Hatamabadi HR. Unintentional home injury prevention in preschool children; a study of contributing factors. Emergency. 2016;72(2);4-27.
  16. Hatamabadi H, Mahfoozpour S, Forouzanfar M, Khazaei A, Yousefian S, Younesian S. Evaluation of parameter related to preventative measures on the child injuries at home.2013;1(3):9-14.
  17. Dolatabadi AA, Mohseninia N, Amiri M, Motamed H, Asl AH. Pediatric trauma patients in Imam Hossein emergency department; an epidemiologic study. Iranian journal of emergency medicine. 2016;3(1):4-8.
  18. Ebrahimipour H, Khani M, Salehabadi S, Heidarabadi AB, Taleghani YM, Mirzaie N, et al. Demographically investigate the trauma resulting from road traffic accidents in injured patients referred to Taleghani Hospital in Mashhad (Khorasan razavi, Iran)2013. Safety Promotion and Injury Prevention. 2015;2(3):60-155.
  19. Safari S, Baratloo A, Negida AS, Taheri MS, Hashemi B, Selkisari SH. Comparing the interpretation of traumatic chest x-ray by emergency medicine specialists and radiologists. Archives of trauma research. 2014;3(4):7-16.
  20. Aghababaeian H, Jamalpor M, Mosavi A, Ghanavati S, Rasoli S, Haji-araghi N. Investigation of causes, time indices, and results of pediatric pre-hospital emergency missions in emergency medical centers affiliated to Dezful University of Medical Sciences, 2011-2012. Sadra Medical Sciences Journal. 2014;2(3)5-19.
  21. Panahi F, Mousavinaeini SM, Azizabadi FM, Asaari S. Ambulance Runs For Pediatric Trauma InTehran. Iranian Journal of Surgery.2007;15(1):6-18.
  22. Mobaleghi J, Molani N. Rate of mortality and injuries from accidents in hospitalized patients in Besat Hospital, Sanandaj. Journal of Shaeed Sadoughi university of medical sciences, Kordestan. 2001:6(24):28.
  23. Ghobani A, Rabiei MR, Charkazi A. Epidemiology of trauma due to collision in shahid motahari hospital of Gonbad-e-Kavous city. 2009;3(1):22-28.
  24. Tegtmeyer LC, Herrnstadt GR, Maier SL, Thamm OC, Klinke M, Reinshagen K, et al. Retrospective analysis on thermal injuries in children—Demographic, etiological and clinical data of German and Austrian pediatric hospitals .Approaching the new German burn registry. Burns.2018;44(1):7-150.
  25. Flanagan BE, Gregory EW, Hallisey EJ, Heitgerd JL, Lewis B. A social vulnerability index for disaster management. Journal of homeland security and emergency management. 2011;8(1):12-18.
  26. Miller L, Alele FO, Emeto TI, Franklin RC. Epidemiology, risk factors and measures for preventing drowning in Africa: a systematic review. Medicina. 2019;55(10):637.
  27. Lukaszyk C, Ivers RQ, Jagnoor J. Systematic review of drowning in India: assessment of burden and risk. Injury prevention. 2018;24(6):8-451.
  28. Yousaf M, Ansari RZ, Tanoli AA, Rehman IU, Gul R. Assessment of Poisoning Incidences due to Use of Household Substances in Peshawar. Journal of Gandhara Medical and Dental Science.2018;4(20);36-41.