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Trauma recurrence in the pediatric emergency population.
B W Taylor1, J MacIntyre, P Forgeron
1Emergency Department, Isaac Walton Killam Grace Health Centre for Women, Children and Families, Halifax, Nova Scotia, Canada. btaylor@ccmail.iwkgrace.ns.ca
The Journal of Trauma
|March 24, 1999
Summary
Children with higher emergency department trauma visit counts are at increased risk for future trauma. This finding helps identify at-risk children for early intervention, improving pediatric trauma care.
Area of Science:
- Pediatric emergency medicine
- Trauma research
- Public health
Background:
- Hypothesized link between ambulatory trauma and trauma recurrence in children.
- Children presenting for trauma may have inherent risk factors or be influenced by parental anxiety.
- Learning from traumatic episodes may influence future trauma risk.
Purpose of the Study:
- To determine if emergency department trauma visit count predicts future trauma visits.
- To validate models linking trauma visit history to recurrence risk.
- To assess the utility of trauma visit counts as an index for identifying high-risk children.
Main Methods:
- Retrospective chart review of billing data from 16,994 patients (1997-1998).
- Analysis of trauma visit count in 1997 (TC97) as a predictor of trauma visits in 1998.
- Examined relationship across age categories and genders.
Main Results:
- A linear relationship was found between TC97 and future trauma visits (OR 3.8-6.4 for TC97 ≥3).
- This association was consistent across all ages and genders.
- No increased risk for respiratory tract infections was associated with higher TC97.
Conclusions:
- Data support the theory that children with trauma have underlying risk factors.
- Emergency department trauma visit count is a direct predictor of future trauma risk.
- Trauma visit count is a valuable, easily obtained index for identifying children needing intervention.