The impact of pediatric trauma in the Amish community

Objective: To describe the epidemiology of trauma in Amish children and to determine differences in treatment and outcome related to injury mechanism. Study design: In this retrospective review, data were collected on all Amish children with trauma requiring hospital admission. Demographic, interventional, and outcome data were collected. Categorical outcomes were compared by using chi-square, logistic regression, or Fisher exact test; continuous outcomes were compared with analysis of variance. Results: A total of 135 trauma admissions were studied. There was a significant difference of proportion of injury by month (P < .01). The most common mechanisms of injury were falls (39%), buggy versus motor vehicle accidents (MVA; 16%), and animal injuries (14%). A total of 41% of patients required operative procedures, and 50% of subjects required intensive care. Animal injuries and buggy versus MVA were significantly associated with a requirement for surgery, increased length of stay, and increased severity (all P < .01). The overall mortality rate was 3%. There were significant associations between mechanism of injury and outcome scores (P < .05) and hospital charges (P < .05). Conclusions: The spectrum of traumatic injuries is unique among Amish children. These injuries contribute significantly to morbidity and mortality and impose a large monetary burden on the Amish community. Education may decrease the incidence of these events.