Blunt trauma in children: causes and outcomes of head versus extracranial injury.

A subset of the National Pediatric Trauma Registry was analyzed to describe causes and outcomes of blunt trauma among children younger than age 15 years. This subset, of 8639 children with blunt trauma, was divided into three groups according to the injured body region: a group with extracranial injury only (ECI) accounted for one half of the population, and the remainder were equally distributed between a group with head injury only (HI) and one with both conditions (ECI + HI). The three groups were compared with respect to demographic characteristics, external cause of injury, injury severity, and outcomes. Falls were the leading cause of injury in the HI group, where children were younger, whereas traffic-related injuries predominated in children with ECI or ECI + HI. Pedestrian injuries accounted for a significant share of poor outcomes. The highest proportions of deaths and severe injuries were observed in the mixed group (ECI +HI), and the lowest, in the ECI group. In contrast, functional impairments at discharge were most frequently noted in the ECI group, where 60% of the children were discharged with at least one impairment. While only 6% of children with HI were discharged with impairment, those affected exhibited more deficits in cognition and behavior, which are expected to persist longer than dysfunction in activities of daily living.