Highlights
- •Adolescents treated at adult and mixed centers exhibit higher in-hospital mortality.
- •Reporting standards specifically for the adolescent population may be beneficial.
- •Further evaluation of factors associated with this observed difference is warranted.
Abstract
Background
While it is assumed adolescents receive comparable trauma care at pediatric trauma
centers (PTC), adult trauma centers (ATC), and combined facilities (MTC), this remains
understudied.
Methods
We conducted a retrospective cohort study through the NTDB evaluating patients 14–18
years of age who presented to an ACS-verified level 1 or 2 trauma facility between
1/1/2016 and 12/31/2019. Multiple logistic regression analyses were performed to compare
mortality risk among trauma facility verification types.
Results
91,881 adolescents presented after trauma over the four-years. Hypotension, severe
TBI, firearm mechanism, and ISS >15 were associated with increased mortality. Compared
to PTCs, the odds of trauma-related mortality were statistically higher at MTCs (OR
1.82, p = 0.004) and ATCs (OR 1.89–2.05, p = 0.001–0.002).
Conclusions
Injured adolescents receiving care at ATCs and MTCs have higher mortality risk than
those cared for at PTCs. Further evaluation of factors associated with this observed
difference is warranted and may help identify opportunities to improve outcomes in
injured adolescents.
Keywords
Abbreviations:
PTCs (Pediatric Trauma Centers), ATCs (Adult Trauma Centers), MTCs (Mixed Trauma Centers), NTDB (National Trauma Data Bank), ACS (American College of Surgeons), ISS (Injury Severity Score), AIS (Abbreviated Injury Score), IRB (Institutional Review Board), SBP (Systolic Blood Pressure), TBI (Traumatic Brain Injury), GCS (Glasgow Coma Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 28, 2022
Accepted:
August 24,
2022
Received in revised form:
July 10,
2022
Received:
March 18,
2022
Identification
Copyright
Published by Elsevier Inc.
