Pediatric trauma centers use less imaging than adult centers for adolescent patients
With Dr. Rich Falcone · hosted by Dr. Todd Ponsky
Part of
Trauma 11 items
Chapter 1 of 4 · Evidence & Research
Introduction
Introduction and article overview
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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 the 15-19 year old adolescent age group is less clear.
Mortality is not the most important or reliable outcome for pediatric trauma because most children survive once they reach a hospital.
This article adds to evidence that pediatric trauma centers add value for children even into the adolescent age range.
51% of severely injured adolescents go to adult trauma centers, necessitating that adult centers achieve equivalent imaging practices and lengths of stay to pediatric trauma centers.
Pediatric trauma centers can achieve the same outcomes as adult centers while using less imaging by trusting clinical diagnosis and clinical examination.
Achieving equivalent outcomes with less imaging, shorter length of stay proves that severely injured adolescents can be cared for without the radiation exposure associated with more imaging.
A prior Ohio-only study showed no difference in outcomes for 15-19 year olds whether treated at adult or pediatric trauma centers.
The study included patients age 15-19 with injury severity scores greater than 25, representing severely injured patients.
Over five years, nearly 13,000 patients met study criteria, with 51% treated at adult trauma centers and 49% at pediatric trauma centers.
The two groups (adult vs pediatric trauma center patients) were demographically very similar without significant differences.
Median injury severity score was 33 and 45% had Glasgow Coma Score less than 8, indicating severe brain injury.
There was no significant difference in mortality between severely injured adolescents treated at adult versus pediatric trauma centers.
At adult trauma centers, adolescent patients were approximately 81% more likely to have an imaging study performed compared to pediatric trauma centers.
Patients at pediatric trauma centers had shorter length of stay and shorter ICU length of stay compared to 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.