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A Novel Approach to Assessment of US Pediatric Trauma System Development
Mary E Fallat1,2,3, Colin Treager4, Sophie Humphrey5
1Norton Children's Hospital, Louisville, Kentucky.
JAMA Surgery
|September 21, 2022
Summary
A robust pediatric trauma system significantly reduces child injury deaths. This study developed the Pediatric Trauma System Assessment Score (PTSAS) to measure state preparedness, revealing wide variations in capabilities nationwide.
Area of Science:
- Emergency Medicine
- Public Health
- Pediatric Trauma Care
Background:
- Mature trauma systems are essential for national, state, and local resilience against disasters.
- Current pediatric state trauma system plans lack standardization and objective effectiveness measures.
Purpose of the Study:
- To develop objective measures of state-level pediatric trauma system capabilities.
- To identify variations in capabilities between states.
- To report on the current status of national pediatric trauma system planning.
Main Methods:
- A national survey in 2018 assessed state pediatric trauma system capabilities.
- A 14-member consensus panel used Delphi methodology to define ideal pediatric trauma system components.
- The Pediatric Trauma System Assessment Score (PTSAS) was developed based on survey and panel data.
Main Results:
- The consensus panel identified 6 key domains for pediatric trauma systems.
- State PTSAS scores varied significantly, ranging from 48.5 to 100.
- Each 1-point increase in PTSAS was associated with a 0.12 per 100,000 decrease in pediatric injury mortality.
Conclusions:
- A stronger pediatric trauma system is significantly linked to lower pediatric injury mortality.
- This study provides a national assessment of pediatric trauma care capabilities and preparedness.
- The findings can guide state, regional, and national planning to improve pediatric trauma care.
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