Are Pediatric Trauma Transfers Justified?: A Unique Viewpoint From a Transferring Institution

Area of Science:

• Pediatric Trauma Care
• Healthcare Management
• Transfer Medicine

Background:

• Current definitions of pediatric overtriage and unnecessary transfers are center-specific and offer limited value for referring institutions.
• This study examines factors influencing patient transfers from a peripheral pediatric trauma center.

Purpose of the Study:

• To analyze the reasons and characteristics of pediatric transfers from a Level 2 to Level 1 pediatric trauma center.
• To evaluate the effectiveness of existing overtriage definitions in a peripheral setting.

Main Methods:

• A 4-year retrospective review of the trauma registry at a Level 2 pediatric trauma center.
• Identification and analysis of pediatric patients transferred to Level 1 centers, including their outcomes.

Main Results:

• 46 pediatric transfers occurred over 4 years (6.6% transfer rate).
• Neurosurgical (21) and burn (12) cases were most common reasons for transfer.
• Pediatric overtriage (LOS < 24 hours) was 46.7%, often due to neurosurgery consults and medicolegal concerns.

Conclusions:

• Existing overtriage definitions have limited utility for interventions at referring centers.
• Improving local availability of pediatric surgical specialists may reduce unnecessary transfers and overtriage.