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Outcomes better for teens treated at pediatric trauma centers :

July 1, 2016

Severely injured teens ages 15-19 years who were treated at pediatric trauma centers fared better with less invasive testing than those treated at adult centers, according to a retrospective review of data from National Trauma Data Bank. 

More trauma centers that treat only pediatric patients are opening, but studies on how they compare with adult centers have had mixed results.

The authors of this study sought to determine whether there were any differences in diagnostic imaging, invasive procedures and mortality among patients treated at pediatric trauma centers vs. those treated at adult centers. They also compared intensive care unit (ICU) and hospital length of stay and discharge disposition.

Data were reviewed on 12,861 adolescents with Injury Severity Scores greater than 25 who were treated at Level 1 centers from 2007-’11.

Results showed that 89% of patients sustained a blunt injury, and 51% were brought to an adult center. Those treated at an adult center were more likely to be older and nonwhite.

Patients with blunt trauma were more likely to have CT scans and invasive procedures such as laparotomy and craniotomy if they were at adult centers, while intracranial pressure monitor placement was more common for those treated at pediatric centers. In addition, those with blunt trauma had shorter median length of stay in the ICU and higher home discharge rates if they were cared for at a pediatric center.

Mortality did not differ between pediatric and adult trauma centers for those with blunt trauma or penetrating injuries.

“With several favorable outcomes and no difference in mortality, PTC (pediatric trauma center) is an appropriate destination for the treatment of severely injured adolescents regardless of mechanism of injury,” the authors concluded.

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