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Is paediatric trauma severity overestimated at triage? An observational follow‐up study
Author(s) -
DO H. Q.,
HESSELFELDT R.,
STEINMETZ J.,
RASMUSSEN L. S.
Publication year - 2014
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12222
Subject(s) - medicine , triage , observational study , injury severity score , paediatric intensive care unit , emergency medicine , pediatrics , major trauma , intensive care unit , significant difference , injury prevention , poison control , surgery
Background Severe paediatric trauma is rare, and pre‐hospital and local hospital personnel experience with injured children is often limited. We hypothesised that a higher proportion of paediatric trauma victims were taken to the regional trauma centre ( TC ). Methods This is an observational follow‐up study that involves one level I TC and seven local hospitals. We included paediatric (< 16 years) and adult (≥ 16–≤ 79 years) trauma patients with a driving distance to the TC > 30 minutes. The primary end‐point was the proportion of trauma patients arriving in the TC . Results We included 1934 trauma patients, 238 children and 1696 adults. A total of 33/238 children (13.9%) vs. 304/1696 adults (17.9%) were transported to the TC post‐injury ( P = 0.14). Among these, children were significantly less injured than adults [median Injury Severity Score ( ISS ) 9 vs. 14, P < 0.01]. There was no significant difference between the groups in the proportion of seriously injured trauma victims ( ISS > 15) taken to the TC [8/11 (72.7%) vs. 139/182 (76.4%)]. The corresponding figures for ISS < 15 were 25/227 (11.0%) and 164/1509 (10.9%), respectively. No significant difference was found in intensive care unit length of stay or time to TC arrival. No paediatric vs. 36/1671 (2.2%) adult deaths were observed at 30‐day follow‐up ( P = 0.03). Conclusions There was no difference in the proportion of paediatric and adult trauma patients transported to the TC , neither overall nor among severely injured patients. Paediatric trauma patients admitted to the TC were, however, significantly less injured than adults.