Comparison of Outcomes for Injured Children at adult trauma centers and pediatric Trauma Centers: A review

Aim: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 PTC (pediatric trauma centers).Materials and Methods: A retrospective analysis of thousands injured children entered in different trauma centers was conducted. Patients were stratified according to mechanism of injury, injury severity, specific organ injury, and type of trauma center: PTC; ATC or ATC with added qualifications to treat children (ATC AQ). Mortality was the major outcome variable measured.Results:Total sample of 66,702 children was analyzed, with an overall mortality of 3.9%. Most injured children were treated at a PTC or ATC AQ. The majority of children below 10 years of age were admitted to PTC. The adjusted odd of mortality was 20% lower for children seen at PTC or 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 PTC / ATC-AQ and had the best overall outcome when treated at PTC. Survival for head, spleen, and liver injuries was significantly better at PTC compared with ATC AQ or ATC.Conclusion:Improved overall survival is associated with pediatric trauma patients treated at PTC/ATC-AQ. This difference in outcome may be attributable to the approach to operative and nonoperative management of head, liver, and spleen injuries at PTC.

کلیدواژه ها:

Pediatric trauma center ، Trauma outcome