OBJECTIVE: To identify causes of hospital attendance or deaths due to external causes of morbidity and mortality (accidents or violence) and types of injury among children under the age of 15 who lived in Londrina, Paraná, Brazil, in 2001. METHODS: Cross-sectional study, with retrospective data collection. Medical records of the five general hospitals and the Mortality Information Centre of the city were the source of morbidity and mortality data, respectively. External causes and types of injury were classified according to the International Classification of Diseases. RESULTS: Out of 8,854 children, 95.7% received care in emergency rooms and were discharged. Among victims seen in emergency rooms, falls were the main type of accident (33.9%), followed by events of undetermined intent (31.8%), and accidents caused by inanimate forces (15.5%), especially by foreign bodies in natural orifices (4.6%) or through the skin (3.2%). At this level of care, superficial trauma (32.9%) and open wounds (29.3%) were the main types of injury. Among children who were admitted to hospitals, falls were also the main type of accident (32.4%), followed by transportation accidents (19.5%), accidents caused by inanimate forces (15.7%), and poisoning (13.5%). Superficial trauma (22.0%) and fractures (19.5%) prevailed among admitted children. Transportation accidents (44.4%) and drowning (16.7%) were the main external causes of death and intracranial trauma (50.0%) the main type of fatal injury. CONCLUSIONS: The causes and types of injury differ according to the level of care and indicate the need of restructuring healthcare services in order to decentralize care to less complex injuries.
Child; Adolescent; Accidents; Violence; Emergency medical services; Morbidity; Mortality
