title: Impact of Trauma System Preparedness on the Outcomes of Severe Child and Adolescent Injuries.
abstract: Severe child trauma poses a heavy burden upon the public's health and the nations' economies, in terms of mortality, morbidity, and disability. The burden varies by the maturity level of the adopted trauma system. This work aimed to identify the impact of trauma system maturity upon the outcomes of care of severely injured children. Discharge data for hospitalized trauma children in Florida (mature trauma system) and Indiana (immature trauma system) were retrospectively analyzed. All severely injured children, 1-15 years of age with an injury severity score ≥25 during 1999-2000 were included. Assessment involved the differences in specified treatment procedures, survival rates, hospital length of stay, and the need for post-hospital institutional care. Analysis revealed that Indiana children significantly stay longer in hospital, and that no differences in the rates of patient mortality, discharge home, and selected procedures were found. Trauma system maturity impacts the volume and complexity of interventions, as well as the mortality, morbidity, and disability associated with the severe child and adolescent trauma. The cost of such burden could be directed to improving quality of the state's injury management services.
authors.affiliation: Preventive Medicine Department, Armed Forces Hospitals, PO Box 1347, 21944 Taif, Kingdom of Saudi Arabia.
authors.forename: Raouf
authors.initials: R
authors.lastname: Afifi
keywords: Immature trauma system; Injury severity score ≥25; Mature trauma system; Pediatric trauma; Trauma outcomes