PEDIATRIC TRAUMA PATIENTS IN AN ‘ADULT' TRAUMA CENTER

Abstract

The injury patterns, age distribution, and outcome of pediatric patients (age 9; significant injuries (AIS score ≥ 3) of the head and extremities were dominant; 3.9% of patients underwent laparotomy, primarily for injuries to the bowel, spleen, and liver. There was only one laparotomy in the 0–4 year age group. The mean length of stay of patients was 6.2 days, with 38% requiring time in the ICU. Of the patients, 90% were discharged home; the treated trauma patient mortality rate was 25 of 988, or 2.5%; 92% of these died of nonsurvivable head injuries. No deaths were judged preventable. There was no significant difference of noncompliance for the pediatric patients when compared with the adult population in five trauma audit filters. The z score analyses (n = 392) were within normal limits. For pediatric trauma admissions to an “adult” suburban level I trauma center, one third were adolescent; only one fourth were preschool; abdominal surgery was uncommon (rare in preschool); mortality was from nonsurvivable head injury; and outcome as measured by mortality, peer review, and patient disposition appeared favorable. The presence of a pediatric trauma surgeon and a separate pediatric trauma service may not be essential or practical.