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Pediatric trauma mortality in India and the United States: A comparison and risk-adjusted analysis

Stas Amato1, Katherine Culbreath2, Emma Dunne3

  • 1Department of Surgery, University of Vermont Medical Center, 111 Colchester Ave, Burlington, VT 05401, USA.

Journal of Pediatric Surgery
|November 3, 2022
PubMed

Insights

Pediatric trauma mortality is significantly higher in India than in the US, especially for children with less severe injuries. Improving trauma care protocols in India could save young lives.

Area of Science:

  • Global Health
  • Trauma Surgery
  • Pediatric Critical Care

Background:

  • Limited research exists on pediatric trauma mortality disparities between high-income and low- to middle-income countries.
  • This knowledge gap hinders targeted interventions for specific populations and injury patterns.

Purpose of the Study:

  • To compare independent predictors of pediatric trauma mortality between India and the United States (US).

Main Methods:

  • Retrospective cohort study of pediatric trauma patients (<18 years) from India (TITCO) and US (NTDB) databases (2013-2015).
  • Analysis of demographic, injury, physiologic, and outcome data.
  • Multivariable regression models to identify independent mortality predictors.

Main Results:

  • 126,678 patients included (India: 3,373; US: 123,305).
  • Indian pediatric trauma patients were younger, had higher injury severity scores, lower blood pressure, and a higher case fatality rate (13.0% vs. 1.0%).
  • Injury in India was the strongest mortality predictor (OR 22.70); highest mortality odds were in children with lower injury and physiologic severity.

Conclusions:

  • Risk-adjusted pediatric trauma mortality is substantially higher in India compared to the US.
  • Disparities are most pronounced in children with less severe injuries, suggesting systemic care differences.
  • Low-cost interventions in trauma care, protocols, training, and imaging may reduce pediatric injury mortality in India.
Abstract

Keywords:
Global healthOutcomes analysisPediatric trauma

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