Impact of Trauma Center Type on Outcomes in Pediatric Population Following Severe Isolated Blunt Traumatic Brain Injuries: A National Analysis.

Autor:	Nasef H; Kiran Patel College of Allopathic Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA., Chin B; John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA., Breeding T; Kiran Patel College of Allopathic Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA., Bundschu N; Kiran Patel College of Allopathic Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA., Wright DD; John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA., Plumely D; Department of Pediatric Surgery, Orlando Health, Arnold Palmer Children's Hospital, Orlando, FL, USA., Elkbuli A; Division of Trauma and Surgical Critical Care, Department of Surgery, Orlando Regional Medical Center, Orlando, FL, USA.; Department of Surgical Education, Orlando Regional Medical Center, Orlando, FL, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2024 Jun 20, pp. 31348241262432. Date of Electronic Publication: 2024 Jun 20.
DOI:	10.1177/00031348241262432
Abstrakt:	Introduction: This study aims to evaluate the association between trauma center type, verification level, and clinical outcomes in pediatric trauma patients with moderate and severe isolated blunt traumatic brain injury (TBI). Methods: This is a retrospective cohort study utilizing the American College of Surgeons (ACS) Trauma Quality Program (TQP) Participant Use File (PUF) database from 2017 to 2021. Severely injured pediatric (<18 years) trauma patients with isolated moderate and severe TBI (AIS head >2, all other body regions <3) were included. Outcomes included in-hospital mortality, discharge disposition, intensive care unit length-of-stay (ICU-LOS), and ventilator-free days (VFDs). Results: Patients treated at a level-I combined adult and pediatric trauma centers (CTCs) had significantly lower odds of in-hospital mortality than those treated at adult trauma centers (ATCs) (OR .495, 95% CI 0.291-.841, P = .009). Patients treated at level-I pediatric trauma centers (PTCs) (OR 2.726, 95% CI 2.059-3.609, P < .001) and level-II PTCs (OR 6.18, 95% CI 3.402-11.239, P < .001) were significantly more likely to be discharged home than equivalent-level ATCs. Conclusion: Pediatric patients with isolated blunt moderate and severe TBI treated at level-I PTCs and CTCs had reduced odds of in-hospital mortality compared to level-I ATCs. Patients at level I and II PTCs had significantly higher odds of discharge home than those at equivalent-level CTCs and ATCs. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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