Twitter  Linkedin
 

Back to 2016 Annual Meeting


Undertriage of Pediatric Major Trauma Patients in the United States
Jin Peng, MD, MS1,2, Krista Wheeler MS1, Jonathan I. Groner, MD1,3,4, Kathryn J. Haley, MS, BSN, RN4, Huiyun Xiang, MD, MPH, PhD1,2,3. 1Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA, 2The Ohio State University College of Public Health, Columbus, OH, USA, 3The Ohio State University College of Medicine, Columbus, OH, USA, 4Trauma Program, Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA.

Background: Previous research showed that one third of major trauma patients were undertriaged in the United States. Small and regional studies suggested that a significant proportion of pediatric trauma patients were treated at adult trauma centers (ATCs). The undertriage rate in U.S. pediatric major trauma patients and the proportion of those treated at ATCs remain unknown.

Methods: We used the 20062010 Nationwide Emergency Department Sample to estimate the national rate of undertriage in pediatric major trauma patients (age≤16 and injury severity score [ISS]>15). We examined the risk factors for undertriage or being treated at ATCs, and identified the most common diagnoses.

Results: In the 20062010 NEDS, there were 55,623 pediatric major trauma patients. Of these patients, 26.6% were undertriaged, and 63.8% were treated at ATCs. Patients without insurance were at significantly higher risk of being undertriaged [odds ratio (OR) =1.50; 95% confidence interval (CI), 1.092.05], as were those living in rural areas (OR=1.54; 95% CI, 1.032.31). Patients at older ages were more likely to be treated at ATCs (OR=1.36; 95% CI, 1.081.70), as were those with chronic conditions (OR=1.92; 95% CI, 1.632.27). TBI was the most common diagnosis seen at NTCs (36.6%). Fracture or dislocation was the most common diagnosis seen at ATCs (42.7%).

Conclusions: Our findings showed that 26.6% of pediatric major trauma patients were undertriaged and almost two thirds were treated at ATCs. It is imperative to develop practical and cost-effective strategies to improve access to pediatric trauma care.


Back to 2016 Annual Meeting