# Characteristics and trends of unintentional injuries among children and adolescents in Kunshan, China: a hospital-based retrospective study, 2018–2023

## TL;DR

This study analyzed trends in unintentional injuries among children in Kunshan, China, from 2018 to 2023, identifying key patterns and using ARIMA models to predict future trends.

## Contribution

The study introduces a refined ARIMA model to predict pediatric injury trends while accounting for pandemic disruptions.

## Key findings

- Males and children aged 3–12 years were most affected by unintentional injuries.
- Falls and burns were the most common injuries, with a notable decline during the pandemic.
- The ARIMA model predicted a slight downward trend in injuries for 2024–2026.

## Abstract

This study aimed to characterize the epidemiological trends and mechanisms of pediatric unintentional injuries in Kunshan, China (2018–2023) and to develop time series models to predict future trends.

A retrospective analysis was conducted on 77,379 pediatric unintentional injury cases, stratified by age, gender, and injury categories. Subgroup analyses targeted children under 5 years. To adjust for pandemic-related disruptions, separate comparisons between 2018 and 2023 were performed. Time series analysis employed an ARIMA model, with model selection based on information criteria and residual diagnostics, and a non-COVID-19 dataset (2018, 2019, and 2023) for forecasting future trends.

Males constituted 62.76% of cases, with a mean age of 5.37 ± 3.55 years. The primary age groups were 3–6 years and 6–12 years, which accounted for 60% of the total population. Falls (21.36%) and transport injuries (4.00%) predominated, with limbs being the most injured body part (59.08%). Contusions/abrasions (41.54%) and sprains/strains (31.21%) were common. Subgroup analysis was performed in children under 5 years old, with 22,110 being males (57.5%) and 16,291 being females (42.5%). Among this group, falls and burns were identified as the most frequent incidents. Unintentional injury cases decreased significantly during COVID-19 (2020–2022). The refined ARIMA(1,1,2) (0,1,1)[12] model, excluding pandemic effects, achieved a mean absolute percentage error of 6.46% while revealing seasonal patterns and predicting a slight downward trend for 2024–2026.

Pediatric unintentional injuries in Kunshan exhibited gender and age-specific patterns, with COVID-19 altering injury profiles. The ARIMA model can capture the seasonal patterns of unintentional injuries to a certain extent, facilitating public health planning and intervention strategies.