Characteristics of childhood home accidents admitted to the Akdeniz University Hospital, between 2015-2016

Characteristics of Childhood Home Accidents Admitted to the Akdeniz University Hospital, between 2015-2016 It is known that more than one third of the serious injuries that occur in children actualize in the home environment. Children are at significant risk of home accidents due to their limited mobility, their interest and curiosity about the objects in their surroundings, they learn by trial and error, they are fearless, and they lack of awareness of the hazards. In this study, it was aimed to obtain data about home accidents in childhood, to evaluate the injuries from medicolegal perspective, to draw attention to the frequency and severity of home accidents in childhood, to contribute determination of the measures that could be taken to protect children from home accidents and the regulations that could be done. In our study, all ICD-10 codes (the inter-codes and all subgroups of S00-S99, T00-T32, T36-T65, X00-X19, X40-X49, W05-W40, W65-W70, W73-W80, W85-W87, Y10-Y30 and J68, J69, J93, R98, R99, T71, W00, W01, W44, W45 codes and their subgroups) that might be related to home accidents and injuries that could occur were searched by Mia-Med Hospital Information Management System used in our hospital and data were obtained retrospectively. A total of 1835 cases under 18 years of age who were admitted to the Akdeniz University Hospital, between 01 January 2015 and 31 December 2016 with a history of domestic accidents were evaluated in terms of properties such as demographic features, types of accidents, part of house where the accident occurred, time of accident (season, month, day, hour), types of injuries, injured body parts, whether or not there is a life-threatening injury, whether the injury cause bone fracture or not, whether the injury is recoverable by simple medical intervention or not, treatment modalities, total treatment durations, frequency of disability/death, total cost, forensic reporting status of cases. There were 1835 cases who had home accidents; 1044 (56.9%) of the cases were male while 791 (43.1%) were female children. It was found that the mean age of cases was 45 months (0 being the smallest, 215 being the largest) and home accidents peaked in the 13-24 month group (n:494, 26.9%) at most. It was noteworthy that 1504 of the cases (82%) were in the 0-6 age group. It was determined that domestic accidents occured most frequently during the summer (n:526, 29%), in June (n:189, 10.3%), on Friday (n:278, 15.1%), from 18:00 to 23:59 hours (n:903, 36.6%). According to their histories the accidents occurred mostly in the living room (n: 672, 36.6%). The most frequent types of home accidents were falls (n:960, 52.4), collisions (n:266, 14.5%) and poisinings (n:195, 10.7%). Two hundred and eighty six (29.8%) of falling cases fell from their own level, 223 (23.2%) of cases fell from armchairs, sofas and divans and 179 (18.6%) of cases fell from beds, cots, cribs and such objects. It was determined that the cases of collision types crashed mostly coffee tables, tables, television units, wardrobes and such furnitures. Fifty three (27.2%) cases of poisoning (n: 195) were intake pharmacological agents and 142 (72.8%) were poisoned by non-pharmacological agents. It was registered that 1337 (72.9%) of all cases were injured, 408 (27.1%) of the children had no evidence of injury. Isolated incisions (n: 534, 39.8%), isolated soft tissue traumas and isolated fractures (n: 148, 10.9%) were the most frequent injury types. It was found that the most injured body parts were head-neck (n: 801, 60%) and upper extremity (n.231, 17%). In 107 of all injured cases (n:1337), injuries were life-threatening severity, while 366 (27.3%) cases had a injury which were unrecoverable by simple medical intervention and 207 (15.4%) cases had a bone fractures or dislocation injuies. According to the our medical files; only 451 (24.6%) of all home-accident cases were reported as a forensic case. It was detected that 1466 (79.9%) cases were treated outpatient and discharged, 308 of cases treated in hospital services (n:276) or intensive care units (n:32) and 14 of cases were referred to other hospitals. Cases who hospitalized to the services or intensive care units were found to be treated on an average of 4.43 days (minimum 1 day, maximum 62 days). The number of cases who died due to home accidents was 6 (0.4%) and in 10 cases (0.7%) results with permanent disability state. It was calculated that the total treatment cost of the cases was 439386,00 TL (about $91538,00 or €78461,00) and the average treatment cost per person was 239,45,00 TL (minimum 13,00 TL, maximum 31462,00 TL). A multidisciplinary approach, such as careful supervision and follow-up of children by caregivers, training of parents about arrangements to be made in the home, providing a safe environment for the children, housing standards and legislative regulations related to product safety, is needed to protect children from home accidents. In addition, "child abuse" should always be kept in mind when there is a case of home accident, and in suspected cases, retinal examination must be asked from ophthalmologists, all skeletal radiographs should be examined, experienced staff should take a detailed history in this regard and forensic case reporting should be done in suspected cases. Key Words: Home accident, child, forensic medicine.