Citation

Vavilala MS, Kernic MA, Rivara FP, Zatzick DF, Bell MJ, Wainwright M, Groner JI, Giza CC, Mink R, Ellenbogen R, Boyle LN, Mitchell P, Kannan N. J. Neurotrauma 2013; 30(13): 1129-1136.

Affiliation

University of Washington, Anesthsiology and Pain Medicine, 325 ninth Ave, Seattle, Washington, United States, 98104; vavilala@uw.edu.

Copyright

(Copyright © 2013, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2012.2716

PMID

23343131

Abstract

Background: Outcomes after pediatric TBI are related to pre-treatment factors including age, injury severity and mechanism of injury and may be positively affected by treatment at trauma centers relative to non-trauma centers. This study estimated the proportion of children with moderate to severe TBI who receive care at trauma centers, and examined factors associated with receipt of care at adult (ATC), pediatric (PTC) and adult/pediatric trauma centers (APTC) compared with care at to non-trauma centers (NTC) using a nationally representative database. Methods: The Kids' Inpatient Database was used to identify hospitalizations for moderate to severe pediatric TBI. Pediatric inpatients aged 0 to 17 years, at least one diagnosis of TBI and a maximum head AIS of ≥ 3 were studied. Multinomial logistic regression was performed to examine factors predictive of the level and type of facility where care was received. Results: 16.7% of patients were hospitalized at NTC, 44.2% at Level I or II ATC, 17.9% at Level I or II PTC, and 21.2% at Level I or II APTC. Multiple regression analyses showed receipt of care at a trauma center was associated with age and polytrauma. Conclusions: Almost 84% of children with moderate to severe TBI currently receive care at a Level I or Level II trauma center. Children with trauma to multiple body regions in addition to more severe TBI are more likely to receive care a trauma center relative to a NTC.

Language: en