Pediatric case fatality rates increased from 2011 to 2021

Pediatric case fatality rates have increased over the past decade, driven by a reduction in nonfatal injuries and increasing fatal injuries, according to a research brief published online Oct. 5 in Pediatrics.

Cordelia Mannix, from Middlesex School in Concord, Massachusetts, and colleagues compared trends in fatal and nonfatal injuries in children across intent and mechanism of injury. Data were obtained from 2011 to 2021 for fatal injury and from 2011 to 2020 for nonfatal injury.

The researchers found that fatal injury rates increased from 14.07 to 17.30 per 100,000 from 2011 to 2021. In contrast, there was a decrease in nonfatal injuries, from 11,592.56 to 5,359.73 per 100,000. Decreases in nonfatal unintentional injuries and assaults were seen (54.9 and 59.8 percent, respectively), while a 57.1 percent increase in nonfatal self-harm injuries occurred. Increases of 87.1, 133.3, and 12.5 percent were seen in firearm fatalities, drug poisoning fatalities, and suffocation-related fatalities, respectively.

The leading causes of nonfatal injuries decreased across most mechanisms, including a 52.8 percent decrease in injuries from falls, a 66.7 percent decrease in injuries from overexertion, and a 47.3 percent decrease in motor vehicle occupant injuries. But no change was seen in injuries from drowning, and nonfatal firearm- and poison-related injuries increased (113.1 and 9.9 percent, respectively). The overall case fatality rate increased by 250 percent from 2011 to 2020, with the highest case fatality rates seen for firearm injuries, drowning, and suffocation.

"The divergent trends between fatal and nonfatal injuries highlight the need for a comprehensive approach to childhood injury prevention," the authors write.