TY - JOUR
T1 - Evolution of a level I pediatric trauma center
T2 - Changes in injury mechanisms and improved outcomes
AU - Schlegel, Cameron
AU - Greeno, Amber
AU - Chen, Heidi
AU - Raees, Muhammad Aanish
AU - Collins, Kelly F.
AU - Chung, Dai H.
AU - Lovvorn, Harold N.
N1 - Funding Information:
Cameron Schlegel received salary support from NIH T32 GI Training Grant #5T32DK007673-24.
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/5
Y1 - 2018/5
N2 - 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.
AB - 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.
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U2 - 10.1016/j.surg.2017.10.070
DO - 10.1016/j.surg.2017.10.070
M3 - Article
C2 - 29373171
AN - SCOPUS:85040605333
SN - 0039-6060
VL - 163
SP - 1173
EP - 1177
JO - Surgery (United States)
JF - Surgery (United States)
IS - 5
ER -