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Management of Children and Adolescents with Chest Trauma in Pediatric and Non-Pediatric Departments-A Claims Data
Peter Zimmermann1, Sebastian Kraemer2, Nicolas Pardey3
1Department of Pediatric Surgery, University of Leipzig, 04103 Leipzig, Germany.
Insights
Children with chest trauma receive care in pediatric and adult departments equally. Pediatric departments use CT scans less often, and university hospital trauma patients have more injuries without longer stays.
Area of Science:
- Pediatric Trauma Care
- Thoracic Injuries in Children
- Healthcare Management
Background:
- Chest trauma management in pediatric patients (≤18 years) across pediatric (PD) and non-pediatric (non-PD) departments is under investigation.
- Understanding treatment variations is crucial for optimizing care for young patients with thoracic injuries.
Purpose of the Study:
- To compare the management strategies for pediatric chest trauma in PD versus non-PD settings.
- To identify differences in diagnostic imaging and treatment outcomes based on department type.
Main Methods:
- Analysis of anonymized claims data from German statutory health insurance funds (2010-2019).
- Inclusion of patients ≤18 years with ICD diagnoses S20-S29 (thorax injuries).
- Comparison of demographic, clinical data, and treatment modalities between PD and non-PD.
Main Results:
- 4064 pediatric patients with chest trauma were analyzed; 47.4% were treated in PD.
- CT imaging was significantly less frequent in PD (8.1%) compared to non-PD (23.1%).
- Patients with chest drains at university/maximum care hospitals had more concomitant injuries but similar hospital stays.
Conclusions:
- Pediatric and adult departments manage chest trauma in children and adolescents with similar frequency.
- CT utilization is notably lower in pediatric departments for these patients.
- The association of chest drains at university hospitals with more injuries warrants further clinical validation.
Background:
To investigate the management of children and adolescents with isolated and combined chest trauma in pediatric (PD) and non-pediatric departments (non-PD).
Methods:
Anonymized claims data were provided by two large German statutory health insurance funds, covering 6.3 million clients over a 10-year period (2010-2019). Data were extracted for patients who had an inpatient ICD diagnosis of section S20-S29 (injuries to the thorax) and were ≤18 years of age. Demographic and clinical data were analyzed.
Results:
A total of 4064 children and adolescents with chest trauma were included (mean age 12.0 ± 5.0 years; 55% male). In 1928 cases (47.4%), treatment was provided at PD. Patients admitted to PD underwent CT imaging less frequently (8.1%; non-PD: 23.1%; p < 0.0001). Children with a chest drain treated at university/maximum care hospitals (UM) showed more injuries involving multiple body regions compared with non-UM (25.8% vs. 4.5%; p = 0.0061) without a difference in the length of hospital stay.
Conclusion:
Children and adolescents with chest trauma are treated almost equally often in pediatric and adult departments. CT is significantly less frequently used in pediatric departments. Patients with a chest drain treated at a UM showed more concomitant injuries without a longer hospital stay. However, the clinical validity of this finding is questionable.
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