Cameron Schlegel1, Amber Greeno2, Heidi Chen3, Muhammad Aanish Raees4, Kelly F Collins2, Dai H Chung2, Harold N Lovvorn2. 1. Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: cameron.schlegel@vanderbilt.edu. 2. Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN, USA. 3. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA. 4. Division of Pediatric Cardiac Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Abstract
BACKGROUND: Trauma is the leading cause of mortality among children, underscoring the need for specialized child-centered care. The impact on presenting mechanisms of injury and outcomes during the evolution of independent pediatric trauma centers is unknown. The aim of this study was to evaluate the impact of our single center transition from an adult to American College of Surgeons-verified pediatric trauma center. METHODS: A retrospective analysis was performed of 1,190 children who presented as level I trauma activations between 2005 and 2016. Patients were divided into 3 chronological treatment eras: adult trauma center, early pediatric trauma center, and late pediatric trauma center after American College of Surgeons verification review. Comparisons were made using Pearson χ2, Wilcoxon rank sum, and Kruskal-Wallis tests. RESULTS: The predominant mechanism of injury was motor vehicle crash, with increases noted in assault/abuse (2% adult trauma center, 11% late pediatric trauma center). A decrease in intensive care admissions was identified during late pediatric trauma center compared with early pediatric trauma center and adult trauma center (51% vs 62.4% vs 67%, P < .001), with concomitant increases in admissions to the floor and immediate operative interventions, but overall mortality was unchanged. CONCLUSION: Transition to a verified pediatric trauma center maintains the safety expected of the American College of Surgeons certification, but with notable changes identified in mechanism of injury and improvements in resource utilization.
BACKGROUND:Trauma is the leading cause of mortality among children, underscoring the need for specialized child-centered care. The impact on presenting mechanisms of injury and outcomes during the evolution of independent pediatric trauma centers is unknown. The aim of this study was to evaluate the impact of our single center transition from an adult to American College of Surgeons-verified pediatric trauma center. METHODS: A retrospective analysis was performed of 1,190 children who presented as level I trauma activations between 2005 and 2016. Patients were divided into 3 chronological treatment eras: adult trauma center, early pediatric trauma center, and late pediatric trauma center after American College of Surgeons verification review. Comparisons were made using Pearson χ2, Wilcoxon rank sum, and Kruskal-Wallis tests. RESULTS: The predominant mechanism of injury was motor vehicle crash, with increases noted in assault/abuse (2% adult trauma center, 11% late pediatric trauma center). A decrease in intensive care admissions was identified during late pediatric trauma center compared with early pediatric trauma center and adult trauma center (51% vs 62.4% vs 67%, P < .001), with concomitant increases in admissions to the floor and immediate operative interventions, but overall mortality was unchanged. CONCLUSION: Transition to a verified pediatric trauma center maintains the safety expected of the American College of Surgeons certification, but with notable changes identified in mechanism of injury and improvements in resource utilization.
Authors: Birte Weber; Ina Lackner; Christian Karl Braun; Miriam Kalbitz; Markus Huber-Lang; Jochen Pressmar Journal: Front Pediatr Date: 2021-03-16 Impact factor: 3.418
Authors: Kelly L Vittetoe; Jackson H Allen; Purnima Unni; Katlyn G McKay; Aaron M Yengo-Kahn; Owais Ghani; Pradeep Mummidi; Amber L Greeno; Christopher M Bonfield; Harold N Bo Lovvorn Journal: Trauma Surg Acute Care Open Date: 2022-03-16