Using the Social Vulnerability Index to Examine Disparities in Surgical Pediatric Trauma Patients

Area of Science:

• Public Health
• Health Services Research
• Pediatric Surgery

Background:

• The Social Vulnerability Index (SVI) is a census tract-level measure for identifying populations at risk of adverse health outcomes.
• Understanding disparities in pediatric trauma care is crucial for equitable resource allocation.

Purpose of the Study:

• To apply the SVI to pediatric trauma patients to examine demographic factors and disparities in surgical outcomes.
• To identify specific at-risk populations within the pediatric trauma cohort.

Main Methods:

• Retrospective review of 355 pediatric trauma patients (≤18 years) from 2010-2020.
• Geocoding patient residence to estimate SVI, stratifying into high (≥70th percentile) and low (<70th percentile) groups.
• Comparison of demographics, clinical data, and outcomes between high and low SVI groups using appropriate statistical tests.

Main Results:

• 21.4% of patients had a high SVI.
• High SVI patients were more likely to have government insurance (73.7% vs 37.2%), be of minority race (49.8% vs 19.1%), and sustain penetrating injuries (32.9% vs 19.7%).
• A higher incidence of surgical site infections was observed in the high SVI group (3.9% vs 0.4%).

Conclusions:

• The SVI can identify vulnerable pediatric trauma populations and highlight healthcare disparities.
• Findings suggest the SVI's potential utility in guiding preventative resource allocation and interventions for at-risk pediatric trauma patients.
• Further research is needed to validate the SVI's application in diverse pediatric cohorts.