|
Citation
|
Hosseinpour H, Magnotti LJ, Bhogadi SK, Colosimo C, El-Qawaqzeh K, Spencer AL, Anand T, Ditillo M, Nelson A, Joseph B. J. Trauma Acute Care Surg. 2023; ePub(ePub): ePub. |
|
Abstract
|
BACKGROUND: Inter-facility transfer of pediatric trauma patients to pediatric trauma centers (PTCs) after evaluation in non-tertiary centers is associated with improved outcomes. We aimed to assess the outcomes of transferred pediatric patients based on their severity of the injury, transfer time, and level of receiving PTCs.
METHODS: This is a 3-year (2017-2019) analysis of the ACS-TQIP database. All children (age < 15 years) who were transferred from other facilities to Level I or II PTC were included and stratified by Level of receiving PTCs and injury severity. Outcome measures were in-hospital mortality and major complications.
RESULTS: 67,726 transferred pediatric trauma patients were identified, of which 52,755 were transferred to Level I and 14,971 to Level II. The mean age and median ISS were 7 ± 4 years, and 4[1-6], respectively. 85% were transported by ground ambulance The median transfer time for Level I and II were 93[70-129] and 90[66-128] minutes, respectively (p < 0.001). On multivariable regression, inter-facility transfers to Level I PTCs were associated with decreased risk-adjusted odds of in-hospital mortality among the mildly to moderately injured group (aOR:0.59, p = 0.037) as well as severely injured group with a transfer time of less than 60 minutes (aOR:0.27, p = 0.002).
CONCLUSION: Every minute increase in the interfacility transfer time is associated with a 2% increase in risk-adjusted odds of mortality among severely injured pediatric trauma patients. Factors other than the level of receiving PTCs, such as estimated transfer time and severity of injury should be considered while deciding about transferring pediatric trauma patients to higher levels of care. LEVEL OF EVIDENCE: III Therapeutic/Care Management.
Language: en |