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Outcomes and delivery of care in pediatric injury. J Pediatr Surg 2006 Jan;41(1):92-8; discussion 92-8

Date

01/18/2006

Pubmed ID

16410115

DOI

10.1016/j.jpedsurg.2005.10.013

Scopus ID

2-s2.0-30344484876   124 Citations

Abstract

PURPOSE: To design effective pediatric trauma care delivery systems, it is important to correlate site of care with corresponding outcomes. Using a multistate administrative database, we describe recent patient allocation and outcomes in pediatric injury.

METHODS: The 2000 Kids' Inpatient Database, containing 2,516,833 inpatient discharge records from 27 states, was filtered by E-code to yield pediatric injury cases. Injury Severity Scores (ISSs) were derived for each discharge using ICDMAP-90 (Tri-Analytics, Inc, Forest Hill, MD). After weighting to estimate national trends, cases were grouped by age (0-10, >10-20 years), ISS (< or =15, >15), and National Association of Children's Hospitals and Related Institutions-designated site of care. Measured outcomes included mortality, length of stay, and total charges. Analysis was completed using Student's t test and chi2.

RESULTS: Among 79,673 injury cases, mean age was 12.2 +/- 6.2 years and ISS was 7.4 +/- 7.6. Eighty-nine percent of injured children received care outside of children's hospitals. In the subgroup of patients aged 0 to 10 years with ISS of greater than 15, the mean ISS for adult hospitals and children's hospitals was not significantly different (18.9 +/- 9.1 vs. 19.4 +/- 9.3, P = .08). However, in-hospital mortality, length of stay, and charges were all significantly higher in adult hospitals (P < .0001).

CONCLUSIONS: Younger and more seriously injured children have improved outcomes in children's hospitals. Appropriate triage may improve outcomes in pediatric trauma.

Author List

Densmore JC, Lim HJ, Oldham KT, Guice KS

Authors

John C. Densmore MD Associate Professor in the Surgery department at Medical College of Wisconsin
Keith T. Oldham MD Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Child
Child, Preschool
Databases, Factual
Emergency Service, Hospital
Female
Hospital Mortality
Humans
Infant
Infant, Newborn
Length of Stay
Male
Outcome Assessment (Health Care)
Pediatrics
Resource Allocation
Treatment Outcome
Triage
Wounds and Injuries
jenkins-FCD Prod-387 b0ced2662056320369de4e5cd5f21c218c03feb3