Transfer dynamics of pediatric thoracic trauma patients across Türkiye

Although pediatric thoracic injuries constitute only a small proportion of all childhood injuries, the risk of morbidity and mortality is increased due to the anatomical and physiological characteristics of children. Early diagnosis and timely referral to appropriate centers are critically important, particularly in hospitals with limited advanced imaging, thoracic surgery, and intensive care facilities. This study aims to comprehensively evaluate the interhospital transfer characteristics of pediatric patients with thoracic trauma in Turkey.

The patients' age, gender, nationality, referring-receiving province and region, referral time, distance, and ICD-10 codes were retrospectively evaluated.

A total of 313 patients were examined (78% male; mean age, 11.2 ± 5.8 years). The most common diagnosis was pneumothorax (27.2%). The vast majority of transfers were by road (98.1%), within the province (82.7%), outside working hours (78%), and on weekdays (70.9%). A significant proportion of air transfers were performed during working hours (p = 0.023). No significant relationship was found between diagnoses and either the transfer route or the transfer time. The distance was significantly longer for out-of-province transfers (p < 0.001). Although significance was detected between the transferring and receiving regions and the direction of transfer, it disappeared in subgroup analyses.

Regulating the criteria for the use of air ambulance services is crucial for strengthening national trauma systems, regionalizing pediatric trauma management, and increasing timely access to advanced trauma centers.