Effect of under triage on early mortality after major pediatric trauma: a registry-based propensity score matching analysis.
Details
Serval ID
serval:BIB_E1A5CA729153
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effect of under triage on early mortality after major pediatric trauma: a registry-based propensity score matching analysis.
Journal
World journal of emergency surgery
Working group(s)
TRENAU Group
ISSN
1749-7922 (Electronic)
ISSN-L
1749-7922
Publication state
Published
Issued date
07/01/2021
Peer-reviewed
Oui
Volume
16
Number
1
Pages
1
Language
english
Notes
Publication types: Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Publication Status: epublish
Abstract
Little is known about the effect of under triage on early mortality in trauma in a pediatric population. Our objective is to describe the effect of under triage on 24-h mortality after major pediatric trauma in a regional trauma system.
This cohort study was conducted from January 2009 to December 2017. Data were obtained from the registry of the Northern French Alps Trauma System. The network guidelines triage pediatric trauma patients according to an algorithm shared with adult patients. Under triage was defined by the number of pediatric trauma patients that required specialized trauma care transported to a non-level I pediatric trauma center on the total number of injured patients with critical resource use. The effect of under triage on 24-h mortality was assessed with inverse probability treatment weighting (IPTW) and a propensity score (Ps) matching analysis.
A total of 1143 pediatric patients were included (mean [SD], age 10 [5] years), mainly after a blunt trauma (1130 [99%]). Of the children, 402 (35%) had an ISS higher than 15 and 547 (48%) required specialized trauma care. Nineteen (1.7%) patients died within 24 h. Under triage rate was 33% based on the need of specialized trauma care. Under triage of children requiring specialized trauma care increased the risk of death in IPTW (risk difference 6.0 [95% CI 1.3-10.7]) and Ps matching analyses (risk difference 3.1 [95% CI 0.8-5.4]).
In a regional inclusive trauma system, under triage increased the risk of early death after pediatric major trauma.
This cohort study was conducted from January 2009 to December 2017. Data were obtained from the registry of the Northern French Alps Trauma System. The network guidelines triage pediatric trauma patients according to an algorithm shared with adult patients. Under triage was defined by the number of pediatric trauma patients that required specialized trauma care transported to a non-level I pediatric trauma center on the total number of injured patients with critical resource use. The effect of under triage on 24-h mortality was assessed with inverse probability treatment weighting (IPTW) and a propensity score (Ps) matching analysis.
A total of 1143 pediatric patients were included (mean [SD], age 10 [5] years), mainly after a blunt trauma (1130 [99%]). Of the children, 402 (35%) had an ISS higher than 15 and 547 (48%) required specialized trauma care. Nineteen (1.7%) patients died within 24 h. Under triage rate was 33% based on the need of specialized trauma care. Under triage of children requiring specialized trauma care increased the risk of death in IPTW (risk difference 6.0 [95% CI 1.3-10.7]) and Ps matching analyses (risk difference 3.1 [95% CI 0.8-5.4]).
In a regional inclusive trauma system, under triage increased the risk of early death after pediatric major trauma.
Keywords
Adolescent, Algorithms, Child, Child, Preschool, Female, Hospital Mortality, Humans, Infant, Infant, Newborn, Length of Stay/statistics & numerical data, Male, Propensity Score, Registries, Trauma Centers, Triage/methods, Wounds and Injuries/mortality, Major pediatric trauma, Mortality, Propensity score, Trauma system, Under triage
Pubmed
Web of science
Open Access
Yes
Create date
29/09/2024 12:18
Last modification date
30/09/2024 7:05