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Evolution of a level I pediatric trauma center: Changes in injury mechanisms and improved outcomes

Cameron Schlegel1, Amber Greeno2, Heidi Chen3

  • 1Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

Surgery
|January 27, 2018
PubMed

Insights

Transitioning to a verified pediatric trauma center improved resource utilization and altered injury mechanisms, while maintaining safety standards. Overall mortality remained unchanged, demonstrating effective specialized care for injured children.

Area of Science:

  • Pediatric Trauma Care
  • Surgical Outcomes
  • Public Health

Background:

  • Trauma is a leading cause of mortality in children, necessitating specialized pediatric care.
  • The effects of establishing dedicated pediatric trauma centers on injury patterns and outcomes are not well understood.
  • This study examines the transition of a single center from adult to American College of Surgeons-verified pediatric trauma care.

Purpose of the Study:

  • To evaluate the impact of transitioning from an adult to a verified pediatric trauma center.
  • To analyze changes in mechanisms of injury and patient outcomes.
  • To assess resource utilization and safety following verification.

Main Methods:

  • Retrospective analysis of 1,190 pediatric trauma activations (2005-2016).
  • Categorization into three eras: adult trauma center, early pediatric trauma center, and late pediatric trauma center.
  • Statistical comparison using Pearson chi-squared, Wilcoxon rank sum, and Kruskal-Wallis tests.

Main Results:

  • Motor vehicle crashes were the primary injury mechanism, with a rise in assault/abuse cases.
  • Intensive care admissions decreased in the late pediatric trauma center era (51%) compared to earlier periods (62.4%-67%).
  • Floor admissions and immediate operative interventions increased, while overall mortality remained constant.

Conclusions:

  • Verification as a pediatric trauma center upholds safety standards.
  • The transition led to significant shifts in injury mechanisms.
  • Improved resource utilization was observed, optimizing care for pediatric trauma patients.
Abstract

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