Elder child or young adult? Adolescent trauma mortality amongst pediatric and adult facilities - 08/12/22
, Connor N. Shewmake b, Stephen M. Bowman c, Kyle J. Kalkwarf d, Deidre L. Wyrick a, Melvin S. Dassinger a, R. Todd Maxson aAbstract |
Background |
While it is assumed adolescents receive comparable trauma care at pediatric trauma centers (PTC), adult trauma centers (ATC), and combined facilities (MTC), this remains understudied.
Methods |
We conducted a retrospective cohort study through the NTDB evaluating patients 14–18 years of age who presented to an ACS-verified level 1 or 2 trauma facility between 1/1/2016 and 12/31/2019. Multiple logistic regression analyses were performed to compare mortality risk among trauma facility verification types.
Results |
91,881 adolescents presented after trauma over the four-years. Hypotension, severe TBI, firearm mechanism, and ISS >15 were associated with increased mortality. Compared to PTCs, the odds of trauma-related mortality were statistically higher at MTCs (OR 1.82, p = 0.004) and ATCs (OR 1.89–2.05, p = 0.001–0.002).
Conclusions |
Injured adolescents receiving care at ATCs and MTCs have higher mortality risk than those cared for at PTCs. Further evaluation of factors associated with this observed difference is warranted and may help identify opportunities to improve outcomes in injured adolescents.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Adolescents treated at adult and mixed centers exhibit higher in-hospital mortality. |
• | Reporting standards specifically for the adolescent population may be beneficial. |
• | Further evaluation of factors associated with this observed difference is warranted. |
Keywords : Adolescent, Trauma, Mortality, Pediatric trauma
Abbreviations : PTCs, ATCs, MTCs, NTDB, ACS, ISS, AIS, IRB, SBP, TBI, GCS
Plan
Vol 224 - N° 6
P. 1445-1449 - décembre 2022 Retour au numéro
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