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Impact of trauma system development on pediatric injury care

David P Mooney1, Ivan M Gutierrez, Qiaoli Chen

  • 1Trauma Program, Department of Surgery, Children's Hospital Boston and Harvard Medical School, 300 Longwood Avenue, Fegan 3, Boston, MA 02115, USA. David.Mooney@childrens.harvard.edu

Pediatric Surgery International
|December 19, 2012
PubMed

Insights

Trauma systems reduce childhood injury hospitalizations and improve triage of severely injured children to trauma centers. However, they did not significantly impact overall injury death rates or triage to trauma centers for all injured children.

Area of Science:

  • Pediatric Trauma Care
  • Public Health Systems
  • Injury Prevention and Control

Background:

  • Trauma systems aim to improve survival for severely injured patients by facilitating rapid transport to specialized trauma centers.
  • The effectiveness of trauma systems in pediatric populations, particularly regarding triage and mortality, requires ongoing evaluation.

Purpose of the Study:

  • To analyze the impact of trauma systems on pediatric triage practices and injury mortality rates.
  • To compare hospitalization and death rates for injured children in states with and without established trauma systems.

Main Methods:

  • A population-based study analyzed data from 58,583 injured children (<15 years) hospitalized in New England (1996-2006).
  • Compared outcomes between three states with trauma systems and three states without.
  • Examined trends in trauma center admissions for all injured, severely injured, and brain-injured children, alongside hospitalization and mortality rates.

Main Results:

  • Injury hospitalization rates decreased in both trauma system and non-trauma system states, but decreased more rapidly in states with trauma systems.
  • No significant difference in overall injury death rates was observed between states with and without trauma systems.
  • Trauma systems increased the proportion of severely injured and brain-injured children admitted to trauma centers, with a more rapid increase observed in trauma system states.

Conclusions:

  • Trauma systems are effective in reducing childhood injury hospitalization rates.
  • They improve the likelihood of severely injured and brain-injured children being admitted to appropriate trauma centers.
  • While improving triage for critical pediatric injuries, trauma systems did not significantly alter overall injury mortality rates in this study.
Abstract

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