Evolution of a level I pediatric trauma center: Changes in injury mechanisms and improved outcomes

Cameron Schlegel, Amber Greeno, Heidi Chen, Muhammad Aanish Raees, Kelly F. Collins, Dai H. Chung, Harold N. Lovvorn

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)1173-1177
Number of pages5
JournalSurgery (United States)
Volume163
Issue number5
DOIs
StatePublished - May 2018
Externally publishedYes

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Trauma Centers
Pediatrics
Wounds and Injuries
Child Mortality
Certification
Motor Vehicles
Critical Care
Child Care
Safety

ASJC Scopus subject areas

  • Surgery

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Evolution of a level I pediatric trauma center : Changes in injury mechanisms and improved outcomes. / Schlegel, Cameron; Greeno, Amber; Chen, Heidi; Raees, Muhammad Aanish; Collins, Kelly F.; Chung, Dai H.; Lovvorn, Harold N.

In: Surgery (United States), Vol. 163, No. 5, 05.2018, p. 1173-1177.

Research output: Contribution to journalArticle

Schlegel, Cameron ; Greeno, Amber ; Chen, Heidi ; Raees, Muhammad Aanish ; Collins, Kelly F. ; Chung, Dai H. ; Lovvorn, Harold N. / Evolution of a level I pediatric trauma center : Changes in injury mechanisms and improved outcomes. In: Surgery (United States). 2018 ; Vol. 163, No. 5. pp. 1173-1177.
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