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Outcomes and delivery of care in pediatric injury

John C Densmore1, Hyun J Lim, Keith T Oldham

  • 1Department of Surgery, Division of Pediatric Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA. jdensmor@mcw.edu

Journal of Pediatric Surgery
|January 18, 2006
PubMed

Insights

Pediatric trauma patients, especially younger and more severely injured children, experience better outcomes at children's hospitals. Triage to specialized pediatric trauma centers can improve survival rates and reduce hospital stays.

Area of Science:

  • Pediatric Trauma Care
  • Healthcare Systems Research
  • Injury Epidemiology

Background:

  • Effective pediatric trauma care delivery requires understanding the correlation between care location and patient outcomes.
  • Administrative databases offer valuable insights into pediatric injury patient allocation and outcomes.

Purpose of the Study:

  • To analyze pediatric injury patient allocation across different healthcare facilities.
  • To compare outcomes, including mortality, length of stay, and charges, based on the site of care for pediatric trauma patients.

Main Methods:

  • Utilized the 2000 Kids' Inpatient Database (2,516,833 records) from 27 states, filtering for pediatric injury cases.
  • Calculated Injury Severity Scores (ISSs) and grouped patients by age, ISS, and designated site of care (children's vs. adult hospitals).
  • Employed Student's t test and chi2 for statistical analysis of outcomes.

Main Results:

  • Eighty-nine percent of injured children received care outside of dedicated children's hospitals.
  • For pediatric patients (0-10 years) with severe injuries (ISS > 15), children's hospitals showed significantly lower in-hospital mortality, shorter length of stay, and reduced charges compared to adult hospitals.
  • While ISS was similar between facility types for this subgroup, outcomes significantly favored children's hospitals (P < .0001).

Conclusions:

  • Children's hospitals provide superior outcomes for younger and more severely injured pediatric trauma patients.
  • Optimizing patient triage to appropriate pediatric trauma centers is crucial for improving outcomes.
Abstract

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