Triage of children with moderate and severe traumatic brain injury to trauma centers

Mary A. Kernic, Frederick P. Rivara, Douglas F. Zatzick, Michael J. Bell, Mark S. Wainwright, Jonathan I. Groner, Christopher C. Giza, Richard B. Mink, Richard G. Ellenbogen, Linda Boyle, Pamela H. Mitchell, Nithya Kannan, Monica S. Vavilala*

*Corresponding author for this work

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Outcomes after pediatric traumatic brain injury (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 non-trauma centers (NTC) using a nationally representative database. The Kids' Inpatient Database was used to identify hospitalizations for moderate to severe pediatric TBI. Pediatric inpatients ages 0 to 17 years with at least one diagnosis of TBI and a maximum head Abbreviated Injury Scale score of ≥3 were studied. Multinomial logistic regression was performed to examine factors predictive of the level and type of facility where care was received. A total of 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. We concluded that 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.

Original languageEnglish (US)
Pages (from-to)1129-1136
Number of pages8
JournalJournal of neurotrauma
Volume30
Issue number13
DOIs
StatePublished - Jul 1 2013

Keywords

  • brain injury
  • pediatrics
  • trauma
  • trauma center

ASJC Scopus subject areas

  • Clinical Neurology

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    Kernic, M. A., Rivara, F. P., Zatzick, D. F., Bell, M. J., Wainwright, M. S., Groner, J. I., Giza, C. C., Mink, R. B., Ellenbogen, R. G., Boyle, L., Mitchell, P. H., Kannan, N., & Vavilala, M. S. (2013). Triage of children with moderate and severe traumatic brain injury to trauma centers. Journal of neurotrauma, 30(13), 1129-1136. https://doi.org/10.1089/neu.2012.2716