Differences Between Pediatric & Adult Trauma Centers

There is substantial data showing pediatric trauma centers are better for young children, but evidence for adolescents aged 15-19 is less clear.

A prior Ohio-only study showed no difference in outcomes for 15-19 year olds whether treated at adult or pediatric trauma centers.

The National Trauma Data Bank study included patients aged 15-19 with injury severity scores greater than 25 over a 5-year period, totaling almost 13,000 patients.

51% of severely injured adolescents in the study were treated at adult trauma centers and 49% at pediatric trauma centers.

The median injury severity score (ISS) in the study population was 33.

45% of patients in the study had Glasgow Coma Scale scores less than 8, indicating severe brain injuries.

There was no significant difference in mortality between severely injured 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.

Severely injured adolescents had shorter length of stay at pediatric trauma centers compared to adult trauma centers.

Severely injured adolescents had shorter ICU length of stay at pediatric trauma centers compared to adult trauma centers.

More adolescents were discharged to home (as opposed to rehab or skilled nursing facilities) when treated at pediatric trauma centers compared to adult trauma centers.

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).

Adult trauma centers need to achieve equivalent imaging and length of stay practices to pediatric trauma centers for adolescents, since 51% of this population presents to adult facilities.

A recent study showed that referring hospitals had higher imaging rates than children's hospitals for appendicitis.

Pediatric trauma centers can achieve equivalent outcomes with less imaging by trusting clinical diagnosis and examination, avoiding unnecessary radiation exposure.