Pediatric Trauma center criteria : An outcomes analysis. Commentary.
Annual Meeting of the Section on Surgery of the American Academy of Pediatrics. San Francisco, CA, USA, 1998/10/16.
Trauma centers (TC) are certified based on widely accepted criteria.
These specific criteria rarely are scrutinized individually.
The purpose of this study was to analyze the individual components of a pediatric trauma center for their effect on outcome.
Members of the National Pediatric Trauma Registry were queried about the following : (1) separate pediatric emergency department (ED), (2) pediatric intensive care unit (PICU), (3) pediatric intensivist as PICU director, (4) pediatric surgeon as TC director, (5) in-house attending surgeon, (6) in-house pediatric emergency physician, (7) 24-hour operating room, (8) 24-hour computed tomography (CT) scan.
Outcomes analyzed included mortality, length of stay, time in ED, days in PICU, and disability.
Victims were stratified based on age (<7 or >=7 years) and severity of injury (ISS <= 16,17-35, >=36).
Results were compared using Student's t test and X2 analysis.
A total of 59 of 74 centers responded, 18 were dropped because of low enrollment (mean, 1.6 patients).
Questions 3,4,6, and 7 were eliminated because of skewed data.
An in-house surgeon reduced the amount of time a mildly injured patient (ISS <= 16) spent in the ED (210 v 434 minutes), as did the separate pediatric ED (333 v592 minutes) and pediatric emergency physicians (344 v 507 minutes) in younger patients (>=7 years).
An in-house surgeon reduced the morality rate in older (>=7) severely injured (ISS >= 36) patients (46. (...)
Mots-clés Pascal : Traumatisme, Enfant, Homme, Adolescent, Nourrisson, Hôpital, Personnel sanitaire, Pronostic, Médecin, Chirurgien, Enquête, Organisation, Service hospitalier
Mots-clés Pascal anglais : Trauma, Child, Human, Adolescent, Infant, Hospital, Health staff, Prognosis, Physician, Surgeon, Survey, Organization, Hospital ward
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0405806
Code Inist : 002B30A04D. Création : 22/03/2000.