Treatment outcomes of injured children at adult level 1 trauma centers: are there benefits from added specialized care?

Document Type

Article

Publication Date

4-1-2011

Identifier

DOI: 10.1016/j.amjsurg.2010.10.006

Abstract

Background: Accidental traumatic injury is the leading cause of morbidity and mortality in children. The authors hypothesized that no mortality difference should exist between children seen at ATC (adult trauma centers) versus ATC with added qualifications in pediatrics (ATC-AQ).

Methods: The National Trauma Data Bank, version 7.1, was analyzed for patients aged <18 years seen at level 1 trauma centers. Bivariate analysis compared patients by ATC versus ATC-AQ using demographic and injury characteristics. Multivariate analysis adjusting for injury and demographic factors was then performed.

Results: A total sample of 53,702 children was analyzed, with an overall mortality of 3.9%. The adjusted odds of mortality was 20% lower for children seen at ATC-AQ (odds ratio, .80; 95% confidence interval, .68-.94). Children aged 3 to 12 years, those with injury severity scores > 25, and those with Glasgow Coma Scale scores < 8 all had significant reductions in the odds of death at ATC-AQ.

Conclusions: Improved overall survival is associated with pediatric trauma patients treated at ATC-AQ.

Journal Title

American journal of surgery

Volume

201

Issue

4

First Page

445

Last Page

449

MeSH Keywords

Adolescent; Child; Child Health Services; Child; Preschool; Databases; Factual; Female; Glasgow Coma Scale; Humans; Injury Severity Score; Male; Pediatrics; Survival Analysis; Trauma Centers; Treatment Outcome; United States; Wounds and Injuries

Keywords

Injury; Child; Teen; Level 1 Trauma Center; National Trauma Data Bank; NTDB

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