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Association of Emergency Department Pediatric Readiness With Mortality to 1 Year Among Injured Children Treated at

Craig D Newgard1, Amber Lin1, Jeremy D Goldhaber-Fiebert2

  • 1Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland.

JAMA Surgery
|February 2, 2022
PubMed

Insights

High pediatric readiness in emergency departments (EDs) is linked to better survival for injured children. Trauma centers with higher pediatric readiness scores show improved 1-year survival rates for children after injury.

Area of Science:

  • Pediatric Emergency Medicine
  • Trauma Care
  • Public Health Outcomes

Background:

  • Emergency departments (EDs) show significant variability in their preparedness for pediatric emergencies.
  • High pediatric readiness in EDs is associated with improved in-hospital survival for children in trauma centers.
  • The long-term survival impact of ED pediatric readiness remains largely unknown.

Purpose of the Study:

  • To investigate the association between emergency department pediatric readiness and 1-year survival.
  • To analyze outcomes for injured children presenting to 146 trauma centers.

Main Methods:

  • Retrospective cohort study including injured children (<18 years) from 8 states.
  • Utilized data from 146 trauma centers (2012-2017), with 1-year follow-up.
  • Pediatric readiness measured by the weighted Pediatric Readiness Score (wPRS); primary outcome was 1-year mortality.

Main Results:

  • 88,071 children were included; 2.2% died within 1 year.
  • Children in the highest wPRS quartile (95-100) had a 30% lower hazard of 1-year death compared to the lowest quartile (32-69).
  • Findings remained consistent across subgroups and sensitivity analyses.

Conclusions:

  • Higher pediatric readiness in trauma center EDs is associated with reduced mortality risk for injured children.
  • This association persists up to 1 year post-injury.
  • High ED pediatric readiness is an independent predictor of improved long-term survival in pediatric trauma patients.
Abstract

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