i
A national analysis of pediatric trauma care utilization and outcomes in the United States
-
Jan 2019
Source: Pediatr Emerg Care. 35(1):1-7
[PDF-94.09 KB]
Details:
-
Alternative Title:Pediatr Emerg Care
-
Personal Author:
-
Description:Objectives
More childhood deaths are attributed to trauma than all other causes combined. Our objectives are to provide the first national description of the proportion of injured children treated at pediatric trauma centers (TC), and to provide clarity to the presumed benefit of pediatric TC verification by comparing injury mortality across hospital types.
Methods
We performed a population-based cohort study using the 2006 HCUP Kids Inpatient Database combined with national TC inventories. We included pediatric discharges (≤16yrs) with ICD-9 code(s) for injury. Descriptive analyses were performed evaluating proportions of injured children cared for by TC level. Multivariable logistic regression models were used to estimate differences in in-hospital mortality by TC type (among level-1 TCs only). Analyses were survey-weighted using HCUP sampling weights.
Results
Of 153,380 injured children, 22.3% were admitted to pediatric TCs, 45.2% to general TCs and 32.6% to non-TCs. Overall mortality was 0.9%. Among level-1 TCs, raw mortality was 1.0% ped TC, 1.4% dual TC, and 2.1% general TC. In adjusted analyses, treatment at level-1 pediatric TCs was associated with a significant mortality decrease compared to level-1 general TCs (Adjusted OR 0.6, 95%CI 0.4-0.9).
Conclusions
Our results provide the first national evidence that treatment at verified pediatric TCs may improve outcomes, supporting a survival benefit with pediatric trauma verification. Given lack of similar survival advantage found for level-1 dual TCs (both general/pediatric verified), we highlight need for further investigation to understand factors responsible for the survival advantage at pediatric-only TCs, refine pediatric accreditation guidelines and disseminate best practices.
-
Subject:
-
Source:
-
Pubmed ID:27618592
-
Pubmed Central ID:PMC5344780
-
Document Type:
-
Funding:
-
Place as Subject:
-
Collection(s):
-
Main Document Checksum:
-
File Type:
You May Also Like
[PDF - 395.87 KB]
Email
CDC-INFO
