Document Detail


Triage of children with moderate and severe traumatic brain injury to trauma centers.
MedLine Citation:
PMID:  23343131     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Outcomes after pediatric traumatic brain injury (TBI) are related to pre-treatment factors including age, injury severity, and mechanism of injury, and may be positively affected by treatment at trauma centers relative to non-trauma centers. This study estimated the proportion of children with moderate to severe TBI who receive care at trauma centers, and examined factors associated with receipt of care at adult (ATC), pediatric (PTC), and adult/pediatric trauma centers (APTC), compared with care at non-trauma centers (NTC) using a nationally representative database. The Kids' Inpatient Database was used to identify hospitalizations for moderate to severe pediatric TBI. Pediatric inpatients ages 0 to 17 years with at least one diagnosis of TBI and a maximum head Abbreviated Injury Scale score of ≥3 were studied. Multinomial logistic regression was performed to examine factors predictive of the level and type of facility where care was received. A total of 16.7% of patients were hospitalized at NTC, 44.2% at Level I or II ATC, 17.9% at Level I or II PTC, and 21.2% at Level I or II APTC. Multiple regression analyses showed receipt of care at a trauma center was associated with age and polytrauma. We concluded that almost 84% of children with moderate to severe TBI currently receive care at a Level I or Level II trauma center. Children with trauma to multiple body regions in addition to more severe TBI are more likely to receive care a trauma center relative to a NTC.
Authors:
Mary A Kernic; Frederick P Rivara; Douglas F Zatzick; Michael J Bell; Mark S Wainwright; Jonathan I Groner; Christopher C Giza; Richard B Mink; Richard G Ellenbogen; Linda Boyle; Pamela H Mitchell; Nithya Kannan; Monica S Vavilala;
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2013-06-25
Journal Detail:
Title:  Journal of neurotrauma     Volume:  30     ISSN:  1557-9042     ISO Abbreviation:  J. Neurotrauma     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-07-02     Completed Date:  2014-03-05     Revised Date:  2014-07-01    
Medline Journal Info:
Nlm Unique ID:  8811626     Medline TA:  J Neurotrauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1129-36     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Brain Injuries / therapy*
Child
Child, Preschool
Female
Guideline Adherence*
Hospitals, Pediatric*
Humans
Infant
Infant, Newborn
Logistic Models
Male
Trauma Centers*
Triage / standards*
Grant Support
ID/Acronym/Agency:
R01 NS072308/NS/NINDS NIH HHS; R01 NS072308-01/NS/NINDS NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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