PURPOSE: Trauma systems improve survival by directing severely injured patients to trauma centers. This study analyzes the impact of trauma systems on pediatric triage and injury mortality rates. METHODS: Population-based data were collected on injured children less than 15 years who were admitted to any hospital in New England from 1996 to 2006. Data from three trauma system states were compared to three non-trauma system states. The percentages of injured children, severely injured children, and brain-injured children admitted to trauma centers were determined as well as injury hospitalization and death rates. Time trend analysis examined the pace of change between the groups. RESULTS: A total of 58,583 injured children were hospitalized during the study period. Injury hospitalization rates were initially similar between the two groups (with and without trauma systems) and decreased over time in both. Rates decreased more rapidly in trauma system states compared to those without, (P = 0.003). Injury death rates decreased over time in both groups with no difference between the groups, (P = 0.20). A higher percentage of injured children were admitted to trauma centers in non-trauma system states throughout the study period, and this percentage increased in both groups of states. A higher percentage of severely injured children and brain-injured children were admitted to trauma centers in non-trauma system states and both percentages increased over time. The increase was more rapid in trauma system states for children with severe injuries (P < 0.001) and children with brain injuries (P < 0.001). DISCUSSION: Trauma systems decreased childhood injury hospitalization rates and increased the percentage of severely injured children and brain-injured children admitted to trauma centers. Mortality and overall triage rates were unaffected.
PURPOSE:Trauma systems improve survival by directing severely injured patients to trauma centers. This study analyzes the impact of trauma systems on pediatric triage and injury mortality rates. METHODS: Population-based data were collected on injured children less than 15 years who were admitted to any hospital in New England from 1996 to 2006. Data from three trauma system states were compared to three non-trauma system states. The percentages of injured children, severely injured children, and brain-injured children admitted to trauma centers were determined as well as injury hospitalization and death rates. Time trend analysis examined the pace of change between the groups. RESULTS: A total of 58,583 injured children were hospitalized during the study period. Injury hospitalization rates were initially similar between the two groups (with and without trauma systems) and decreased over time in both. Rates decreased more rapidly in trauma system states compared to those without, (P = 0.003). Injury death rates decreased over time in both groups with no difference between the groups, (P = 0.20). A higher percentage of injured children were admitted to trauma centers in non-trauma system states throughout the study period, and this percentage increased in both groups of states. A higher percentage of severely injured children and brain-injured children were admitted to trauma centers in non-trauma system states and both percentages increased over time. The increase was more rapid in trauma system states for children with severe injuries (P < 0.001) and children with brain injuries (P < 0.001). DISCUSSION: Trauma systems decreased childhood injury hospitalization rates and increased the percentage of severely injured children and brain-injured children admitted to trauma centers. Mortality and overall triage rates were unaffected.
Authors: Ellen J MacKenzie; Frederick P Rivara; Gregory J Jurkovich; Avery B Nathens; Katherine P Frey; Brian L Egleston; David S Salkever; Daniel O Scharfstein Journal: N Engl J Med Date: 2006-01-26 Impact factor: 91.245
Authors: Brian Celso; Joseph Tepas; Barbara Langland-Orban; Etienne Pracht; Linda Papa; Lawrence Lottenberg; Lewis Flint Journal: J Trauma Date: 2006-02
Authors: Mary E Fallat; Colin Treager; Sophie Humphrey; Lindsey Gumer; Kahir Jawad; Elissa Butler; Frederick B Rogers; Frederick P Rivara; Amelia T Collings Journal: JAMA Surg Date: 2022-09-21 Impact factor: 16.681
Authors: Catherine J Bradshaw; Ashwath S Bandi; Zahid Muktar; Muhammad A Hasan; Tanvir K Chowdhury; Tahmina Banu; Mesay Hailemariam; Florence Ngu; David Croaker; Rouma Bankolé; Tunde Sholadoye; Oluwole Olaomi; Emmanuel Ameh; Antonio Di Cesare; Ernesto Leva; Yona Ringo; Lukman Abdur-Rahman; Ramy Salama; Essam Elhalaby; Helen Perera; Christopher Parsons; Stewart Cleeve; Alp Numanoglu; Sebastian Van As; Shilpa Sharma; Kokila Lakhoo Journal: World J Surg Date: 2018-06 Impact factor: 3.352