Improved functional outcome for severely injured children treated at pediatric trauma centers.
BACKGROUND
Controversy exists regarding the impact of pediatric trauma centers (PTC) on survival for injured children. However, functional outcome for children treated at PTC compared with adult trauma centers (ATC) has not been evaluated.


METHODS
An analysis of children entered in the Pennsylvania Trauma Outcome Study between 1993 and 1997 was conducted. Patients were stratified according to type of trauma center: PTC; Level I ATC; Level II ATC; or ATC with added qualifications (AQ). Functional outcome at discharge was analyzed.


RESULTS
For severely injured children, there was an overall trend toward improved functional outcome at PTC compared with ATC AQ and ATC I, but no difference compared with ATC II. PTC showed improved functional outcome at discharge for head injury compared with ATC AQ and ATC I.


CONCLUSIONS
There is an overall trend toward improved functional outcome at discharge for children treated at PTC compared with those treated at ATC AQ and ATC I. Improved outcome for head injury may be a key factor contributing to improved outcome at PTC.
Potoka
D A
DA
Department of Surgery, University of Pittsburgh, and Children's Hospital of Pittsburgh Pittsburgh, Pennsylvania, USA.
Schall
L C
LC
Ford
H R
HR
D000203:Activities of Daily Living; D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002662:Child Health Services / Q000592:standards*; D002675:Child, Preschool; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D008297:Male; D017063:Outcome Assessment, Health Care; D010414:Pennsylvania / Q000453:epidemiology; D020127:Recovery of Function; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014193:Trauma Centers / Q000592:standards*; D014947:Wounds and Injuries / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy