title: Admission patterns in pediatric trauma patients with isolated injuries.
abstract: BACKGROUND
  Pediatric trauma patients presenting with stable, isolated injuries are often admitted to the trauma service for initial management. The purpose of this study was to evaluate admission patterns in trauma patients with isolated injuries and compare outcomes based on admitting service.
  
  
  METHODS
  The institutional trauma registry was retrospectively reviewed for patients presenting from January 2007-December 2012. A total of 3417 patients were admitted to a surgical service and further reviewed. Patients with isolated injuries were further stratified by admission to the general trauma service (GTS, n = 738) versus admission to the subspecialty surgical trauma service (STS, n = 2251).
  
  
  RESULTS
  When compared to patients admitted to GTS, patients admitted to STS with isolated injuries were significantly younger, were more likely to present with injury severity scores ranging from 9-14, Glasgow coma scale ≥ 13, had shorter emergency room length of stay, were more likely to undergo surgery within 24 h, and had fewer computed tomography scans performed. There were no missed injuries in patients with isolated injuries admitted to STS (with 5% having a GTS consult) compared with one missed injury in those admitted to GTS. Patients with isolated injuries admitted to an STS were found to have significantly lower complication rates (0.6% versus 2.2%, P < 0.01).
  
  
  CONCLUSIONS
  Pediatric trauma patients presenting with stable, isolated injuries may be efficiently and safely managed by nontrauma services without an increase in missed injuries or complications.
authors.affiliation: Division of Pediatric Surgery, All Children's Hospital Johns Hopkins Medicine, Outpatient Care Center, Saint Petersburg, Florida. Electronic address: Sfarach1@jhmi.edu.
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Farach
authors.affiliation: Division of Pediatric Surgery, All Children's Hospital Johns Hopkins Medicine, Outpatient Care Center, Saint Petersburg, Florida.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Danielson
authors.affiliation: Clinical and Translational Research Organization, All Children's Hospital Johns Hopkins Medicine, Saint Petersburg, Florida.
authors.forename: Ernest K
authors.initials: EK
authors.lastname: Amankwah
authors.affiliation: Division of Pediatric Surgery, All Children's Hospital Johns Hopkins Medicine, Outpatient Care Center, Saint Petersburg, Florida.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Chandler
mesh_terms: D000293:Adolescent; D002648:Child; D015600:Glasgow Coma Scale; D006760:Hospitalization; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D010343:Patient Admission; D012189:Retrospective Studies; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000628:therapy*
keywords: Admission; Isolated injuries; Pediatric; Trauma