Pediatric trauma patients in an 'adult' trauma center.
The injury patterns, age distribution, and outcome of pediatric patients (age < 15 years) treated in an "adult" trauma center is incompletely defined. A total of 1115 pediatric trauma patients (9.6% total trauma admissions) treated over a 6-year period in a level I suburban trauma center without a pediatric trauma service or a pediatric surgeon were reviewed for age distribution; injury mechanism, injury pattern, and injury severity; surgical procedures; disposition; and mortality. All charts were subject to internal and external peer review, including five site surveys. Resuscitation, surgery, critical care, and stepdown management were provided by a trauma team led by in-house attending trauma surgeons (mean PGY = 20). Of the patients 22% were preschool (age 0-4 years), and 34% were adolescent (age 12-14 years); the mechanism was blunt (96%), with motor vehicular crash being the most frequent; the mean ISS was 11.1, with 39% of ISSs > 9; significant injuries (AIS score > or = 3) of the head and extremities were dominant; 3.9% of patients underwent laparotomy, primarily for injuries to the bowel, spleen, and liver. There was only one laparotomy in the 0-4 year age group. The mean length of stay of patients was 6.2 days, with 38% requiring time in the ICU. Of the patients, 90% were discharged home; the treated trauma patient mortality rate was 25 of 988, or 2.5%; 92% of these died of nonsurvivable head injuries. No deaths were judged preventable. There was no significant difference of noncompliance for the pediatric patients when compared with the adult population in five trauma audit filters.(ABSTRACT TRUNCATED AT 250 WORDS)
Division of Trauma, Lehigh Valley Hospital, Allentown, Pennsylvania.
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Rhodes
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Smith
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Boorse
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008505:Medical Staff, Hospital; D012189:Retrospective Studies; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000209:etiology / Q000401:mortality / Q000628:therapy*