Is paediatric trauma severity overestimated at triage?: An observational follow-up study

H Q DO; R Hesselfeldt; J Steinmetz; L S Rasmussen

doi:10.1111/aas.12222

Is paediatric trauma severity overestimated at triage? An observational follow-up study

H Q DO, R Hesselfeldt, J Steinmetz, L S Rasmussen

Department of Clinical Medicine

4 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Acta Anaesthesiologica Scandinavica
Volume	58
Issue number	1
Pages (from-to)	98-105
Number of pages	8
ISSN	0001-5172
DOIs	https://doi.org/10.1111/aas.12222
Publication status	Published - Jan 2014

Keywords

Adolescent
Aged
Aged, 80 and over
Air Ambulances
Child
Child, Preschool
Emergency Medical Services
Endpoint Determination
Female
Follow-Up Studies
Humans
Infant
Injury Severity Score
Intensive Care
Length of Stay
Male
Transportation of Patients
Trauma Centers
Triage
Wounds and Injuries

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10.1111/aas.12222

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title = "Is paediatric trauma severity overestimated at triage?: An observational follow-up study",

abstract = "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.",

keywords = "Adolescent, Aged, Aged, 80 and over, Air Ambulances, Child, Child, Preschool, Emergency Medical Services, Endpoint Determination, Female, Follow-Up Studies, Humans, Infant, Injury Severity Score, Intensive Care, Length of Stay, Male, Transportation of Patients, Trauma Centers, Triage, Wounds and Injuries",

author = "DO, {H Q} and R Hesselfeldt and J Steinmetz and Rasmussen, {L S}",

note = "{\textcopyright} 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",

year = "2014",

month = jan,

doi = "10.1111/aas.12222",

language = "English",

volume = "58",

pages = "98--105",

journal = "Acta Anaesthesiologica Scandinavica",

issn = "0001-5172",

publisher = "Wiley-Blackwell",

number = "1",

}

TY - JOUR

T1 - Is paediatric trauma severity overestimated at triage?

T2 - An observational follow-up study

AU - DO, H Q

AU - Hesselfeldt, R

AU - Steinmetz, J

AU - Rasmussen, L S

PY - 2014/1

Y1 - 2014/1

N2 - 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.

AB - 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.

KW - Adolescent

KW - Aged

KW - Aged, 80 and over

KW - Air Ambulances

KW - Child

KW - Child, Preschool

KW - Emergency Medical Services

KW - Endpoint Determination

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Infant

KW - Injury Severity Score

KW - Intensive Care

KW - Length of Stay

KW - Male

KW - Transportation of Patients

KW - Trauma Centers

KW - Triage

KW - Wounds and Injuries

U2 - 10.1111/aas.12222

DO - 10.1111/aas.12222

M3 - Journal article

C2 - 24308697

SN - 0001-5172

VL - 58

SP - 98

EP - 105

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

IS - 1

ER -

Is paediatric trauma severity overestimated at triage? An observational follow-up study

Abstract

Keywords

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