Related Experiment Video
Updated: Aug 16, 2026
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
The relationship between the location of pediatric intensive care unit facilities and child death from trauma: a
Folafoluwa O Odetola1, William C Miller, Matthew M Davis
1Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor, MI, USA. fodetola@med.umich.edu
Insights
The presence of Pediatric Intensive Care Unit (PICU) facilities is linked to fewer child trauma deaths at the county level. This highlights the importance of PICU accessibility for improving pediatric trauma outcomes.
Area of Science:
- Pediatric critical care medicine
- Public health
- Epidemiology
Background:
- Childhood trauma remains a significant public health concern.
- Geographic disparities in access to specialized pediatric care may influence outcomes.
- Understanding the impact of Pediatric Intensive Care Unit (PICU) facility location is crucial for addressing pediatric trauma mortality.
Purpose of the Study:
- To examine the association between the geographic distribution of PICU facilities and county-level child mortality due to traumatic injuries in the contiguous United States.
- To determine if the presence of PICU facilities correlates with reduced rates of death from trauma in children.
Main Methods:
- A cross-sectional ecological study design was employed.
- County-level data on pediatric trauma deaths (ages 0-14) from 1996-1998 were analyzed.
- Data on the availability of PICU facilities in 1997 were linked to mortality data.
Main Results:
- PICU facilities were available in only 9% of US counties in 1997.
- Counties with PICU facilities demonstrated significantly lower rates of childhood trauma mortality compared to counties without PICUs (IRR = 0.72).
- This association persisted even after adjusting for rurality, income levels, and the presence of adult intensive care units (IRR = 0.82).
Conclusions:
- The study indicates a significant relationship between the presence of PICU facilities and reduced county-level mortality from traumatic injuries in children.
- This association may be attributed to the concentration of pediatric subspecialty care in areas with PICUs.
- Further research using individual-level data is recommended to confirm these findings and explore causal mechanisms.
Objectives:
To describe the relationship between the location of Pediatric Intensive Care Unit (PICU) facilities and county-level child death from trauma in the contiguous USA.
Study Design:
We conducted a cross-sectional ecologic study using county-level data on death due to trauma in children 0 to 14 years of age from 1996 to 1998. These data were linked to 1997 county-level data on availability of PICU facilities.
Results:
In 1997, PICU facilities were present in 9% of USA counties. There were 18,337 childhood deaths from trauma in the study period. The presence of PICU facilities in a county was associated with lower mortality from trauma (incidence rate ratio [IRR] = 0.72; 95% CI 0.67-0.78) compared to counties without PICU facilities. After controlling for residence in rural and low-income counties, and the presence of adult medicosurgical intensive care units, the presence of PICU facilities in a county remained associated with lower rates of death from trauma (IRR = 0.82; 95% CI 0.75-0.89).
Conclusion:
The presence of PICU facilities is related to lower mortality rates due to traumatic injuries at the county level. This finding may reflect the concentration of pediatric subspecialty care in counties with PICUs. This association merits further study with individual-level observations.