Original Research Article| Volume 224, ISSUE 6, P1445-1449, December 2022

Elder child or young adult? Adolescent trauma mortality amongst pediatric and adult facilities


      • 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.



      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.


      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.


      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).


      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.



      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)
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