Differences in survival outcome for severely injured paediatric trauma by type of trauma centre

Rebecca J. Mitchell*, Kate Curtis, Luke Testa, Andrew J A Holland, Soundappan SV Soundappan, Sarah Adams

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Aim: Whether treatment at paediatric trauma centres (PTCs) provides a survival advantage for injured children over treatment at adult trauma centres (ATCs) remains inconclusive. This study examines the association between trauma centre type and in-hospital mortality for severely injured paediatric trauma patients in New South Wales, Australia.

Methods: A retrospective examination of paediatric patient characteristics (aged ≤15years), treatment and injury outcome was conducted using data from the New South Wales Trauma Registry for 2009-2014. Logistic regression was used to examine the association of in-hospital mortality and type of trauma centre.

Results: There were 1230 children who were severely injured (i.e. Injury Severity Score; ISS>12) and 81.0% received definitive care at a PTC. Two-thirds were male, 37.8% were aged 11-15 years and falls represented 32.0% of the injuries. Almost half (48.9%) the injured children had an ISS between 16 and 24, 31.9% between 25 and 39 and 3.8% an ISS between 40 and 75. The mean and median hospital length of stay was 17.5 and 5days, respectively. Fifty percent of children that received definitive care at a PTC were admitted to an ICU compared to 23.9% at a Level 1 ATC. There were 119 (9.7%) in-hospital deaths. Children aged ≤15years who were treated at a Level 1 ATC had 6.1 times higher odds of not surviving their injuries than if treated at a PTC.

Conclusion: Children who received definitive care at a PTC had a survival advantage compared to those treated at a Level 1 ATC. Prospectively examining the processes of care for severely injured children may assist in identification of quality and system changes required to ensure optimal trauma care within the health-care system.

Original languageEnglish
Pages (from-to)808-813
Number of pages6
JournalJournal of Paediatrics and Child Health
Volume53
Issue number8
Early online date24 Mar 2017
DOIs
Publication statusPublished - Aug 2017

Keywords

  • injury severity
  • paediatric
  • trauma centre
  • trauma outcome

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