Agent–host–environment model of blunt abdominal trauma in children: 5-year experience and preventive inferences in Zagazig University-Egypt

Abstract

Background/Purpose Among children aged from 1 to 14 years, approximately 50% of mortality is related to trauma. Abdominal injuries account for approximately 10% of trauma deaths in childhood. Child injury has great effects on communities and countries. The agent–host– environment model has been used to describe the epidemiology of communicable diseases. It can be adapted for understanding childhood injuries. This study aims to evaluate the Zagazig University experience with blunt abdominal trauma (BAT) in children in light of the epidemiological (agent–host–environment) model.
Patients and methods This study included 590 consecutive patients aged from 1 to 14 years, who were admitted to the Emergency Unit at the Zagazig University Hospital, after BAT incidents in the period January 2006–2010. A predesigned format was used to collect targeted data.
Results The study included 590 children with BAT. They made up approximately 18% of total children trauma cases. Multisystem trauma occurred in 72.5% of patients. The causative energy in this study was mechanical energy that was most commonly transmitted through road traffic accidents (55.8%). When mechanisms of trauma were related to age groups, we found that road traffic accidents were significantly more common among children aged from 5 to 14 years (P value < 0.001), whereas falls were significantly more common among children aged from 1 to 4 years (P value < 0.001). The most common physical environment was streets. BAT was more in urban areas (65%) and in low socioeconomic states (67%).
Conclusion According to this study, most BAT vulnerable children are boys aged from 5 to 14 years, living in urban areas, and with low socioeconomic status. The agent– host–environment model can be used to study causative and contributing factors to trauma. It can be utilized to structure and plan preventive interventions against BAT in children.

Keywords: abdominal trauma, agent–host–environment model, blunt
trauma, epidemiological model