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Effect of under triage on early mortality after major pediatric trauma: a registry-based propensity score matching

François-Xavier Ageron1, Jordan Porteaud2, Jean-Noël Evain2

  • 1RENAU Northern French Alps Emergency Network, Public Health Department, Annecy Hospital, F-74000, Annecy, France.

World Journal of Emergency Surgery : WJES
|January 8, 2021
PubMed

Insights

Under-triage in pediatric trauma care significantly elevates the risk of early death. This study highlights the critical need for accurate trauma patient assessment to improve survival rates in children.

Area of Science:

  • Pediatric Trauma Care
  • Emergency Medicine
  • Public Health

Background:

  • Under-triage in pediatric trauma is poorly understood.
  • Regional trauma systems often use algorithms shared with adult patients.
  • Early mortality in pediatric trauma is a critical concern.

Purpose of the Study:

  • To determine the effect of under-triage on 24-hour mortality in pediatric trauma patients.
  • To analyze under-triage rates within a regional trauma system.
  • To quantify the risk of death associated with under-triage in children.

Main Methods:

  • A retrospective cohort study analyzed data from the Northern French Alps Trauma System (2009-2017).
  • Under-triage was defined as pediatric patients needing specialized care transferred to non-Level I centers.
  • Statistical analyses included inverse probability treatment weighting (IPTW) and propensity score (Ps) matching.

Main Results:

  • 1143 pediatric trauma patients were included; 33% experienced under-triage.
  • Under-triage of children requiring specialized care increased the risk of 24-hour mortality.
  • Risk difference for death was 6.0% (IPTW) and 3.1% (Ps matching) in under-triaged patients.

Conclusions:

  • Under-triage in a regional trauma system increases the risk of early death in pediatric major trauma.
  • Accurate triage is crucial for improving outcomes in critically injured children.
  • Findings underscore the importance of tailored pediatric trauma protocols.
Abstract

Keywords:
Major pediatric traumaMortalityPropensity scoreTrauma systemUnder triage

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