Pediatric Trauma Society

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74 Reasons Why: A Silent Epidemic in Teenagers
Alessandra Landmann, MD; Robert Letton, MD; Alisa Cross, MD
University of Oklahoma Health Sciences Center, Oklahoma City, OK

Background - Suicide has become the second leading cause of death in pediatric patients age 10-18. Despite increasing exposure on social media, we hypothesize that trauma centers remain largely unaware of the epidemic secondary to small individual center patient numbers. Our aim is to identify demographic and geographic patterns in at-risk teenagers in a state with only Level 1 trauma center.

Methods - A retrospective chart review was conducted of patients < 17 years-old either admitted with a diagnosis of self-inflicted intentional trauma to our facility or had cause of death consistent with self -inflicted trauma from the state medical examiner.

Results - From January 2015-June 2017, 74 patients were identified from medical examiner and institution data. Only 20/74 patients (27%) presented to our Level 1 facility. Of the patients presenting to our center, average age was 15, they were more likely to be male, Caucasian, live in rural or suburban neighborhoods, and the most common mechanism was penetrating trauma. A total of 59/74 completions occurred throughout the state as determined by the medical examiner, an overall mortality of 79.7%; 5/59 occurred at our facility, a facility specific mortality rate of 20%.

Conclusions - We described a Level one trauma centerís experience with self-inflicted pediatric trauma. Demonstrating, that individual trauma centers have a limited involvement in this lethal process, only 8% of deaths presented to our stateís only trauma center. We propose that teenage suicide presents a silent epidemic that warrants a focus on prevention and education as few patients present to trauma facilities.

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