Differences Between Pediatric & Adult Trauma Centers
With Dr. Rich Falcone · hosted by Dr. Todd Ponsky · StayCurrentMD
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What the experts said
There is plenty of data showing pediatric trauma centers are better for young children, but evidence for adolescents aged 15-19 is less clear.
Mortality is not the most important or reliable outcome for pediatric trauma because most children survive once they reach a hospital.
Pediatric trauma centers add value for children even up into the adolescent age range (15-19 years).
51% of severely injured adolescents are going to adult trauma centers, so adult centers need to achieve equivalent imaging practices and length of stays to pediatric trauma centers.
Pediatric trauma centers can care for severely injured adolescents using less imaging while achieving the same outcomes and shorter lengths of stay.
Clinical diagnosis and clinical examination can be trusted in evaluating severely injured adolescents without requiring extensive imaging.
Severely injured adolescents do not need radiation exposure from extensive imaging when clinical evaluation is adequate.
A previous study looking at Ohio data showed no difference in outcomes for adolescents aged 15-19 whether treated at adult or pediatric trauma centers.
The study by Ashley Walther et al. used the National Trauma Data Bank and included patients aged 15-19 with injury severity scores greater than 25.
Over a 5-year period, the study identified almost 13,000 patients meeting the inclusion criteria, with 51% treated at adult trauma centers and 49% at pediatric trauma centers.
The patient groups at adult and pediatric trauma centers were demographically very similar without significant differences.
The median injury severity score (ISS) for the study population was 33.
45% of patients in the study had a Glasgow Coma Score of less than 8, indicating severe brain injuries.
There was no significant difference in mortality between adolescents treated at adult versus pediatric trauma centers.
Adolescents treated at adult trauma centers were approximately 81% more likely to have an imaging study performed compared to those at pediatric trauma centers.
Patients at pediatric trauma centers had shorter length of stay compared to those at adult trauma centers.
Patients at pediatric trauma centers had shorter ICU length of stay compared to those at adult trauma centers.
More patients were discharged to home (as opposed to rehab or skilled nursing facilities) when cared for at pediatric trauma centers compared to adult trauma centers.