Do Pediatric Trauma Centers Have Better Survival Rates than Adult Trauma Centers? An Examination of the National Pediatric Trauma Registry

Osler, Turner M.; Vane, Dennis W.; Tepas, Joseph J.; Rogers, Frederick B.; Shackford, Steven R.; Badger, Gary J.

doi:10.1097/00005373-200101000-00017

Cited by 149 publications

(90 citation statements)

References 14 publications

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“…2,3 Due to the distinctive biomechanics and anthropometrics of children's spinal cords, 60%-80% of all pediatric cord injuries are cervical. 4 Despite the continued improvements in treatment that help many children survive SCI, most injuries will cause permanent disability.…”

mentioning

confidence: 99%

Diffusion Tensor Imaging of the Normal Pediatric Spinal Cord Using an Inner Field of View Echo-Planar Imaging Sequence

Barakat¹,

Mohamed²,

Hunter³

et al. 2012

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: DTI in the brain has been well established, but its application in the spinal cord, especially in pediatrics, poses several challenges. The small cord size has inherent low SNR of the diffusion signal intensity, respiratory and cardiac movements induce artifacts, and EPI sequences used for obtaining diffusion indices cause eddy-current distortions. The purpose of this study was to 1) evaluate the accuracy of cervical spinal cord DTI in children using a newly developed iFOV sequence with spatially selective 2D-RF excitations, and 2) examine reproducibility of the DTI measures.

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mentioning

confidence: 99%

Diffusion Tensor Imaging of the Normal Pediatric Spinal Cord Using an Inner Field of View Echo-Planar Imaging Sequence

Barakat¹,

Mohamed²,

Hunter³

et al. 2012

AJNR Am J Neuroradiol

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“…Several studies have attempted to determine which types of centers provide the best care to injured children (pediatric trauma centers v. adult trauma centers v. mixed trauma centers), however these studies use overall in-hospital mortality rates as a basis for comparison [5][6][7][8][9]. We believe that the PDR is a more appropriate area of focus as it quantifies the number of patients who died as a result of deficiencies in care.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Mortality andPreventable Death at a Mature Trauma Center

2018

J Emerg Med Critical Care

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Objectives: It is critical to review pediatric mortality and identify preventable/potentially preventable death (PD). We sought to characterize mortality in pediatric trauma patients at our center and identify causes of PD. Methods:A retrospective review of pediatric (<14) trauma deaths (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) at our American College of Surgeons verified level 1 adult/ level 2 pediatric trauma center was conducted. Patients that died from burns, drowning or hanging were excluded. Demographics, clinical characteristics, and autopsy data were collected. Injury severity (ISS) and trauma & injury severity (TRISS) scores were calculated for each patient. Injuries were classified as non-survivable if they involved an ISS of 75. Death after non-survivable injury was considered nonpreventable. A multi-disciplinary panel reviewed all mortalities and rendered decisions regarding preventability and causes of PD.Results: 49 of 3,065 patients died over the study period (MR=1.6%). Patients that died were primarily male (73%) with severe injuries (ISS 32 (19)) caused by a blunt (85%) mechanism. Fifteen deaths (31%) were the result of non-accidental trauma (NAT). Seven patients had an ISS of 75 indicating non-survivable injuries. After calculating TRISS on the remaining 42 patients, 12 patients had a >50% probability of survival. 25% of patients with a TRISS >50% were determined to be PD's for an overall preventable death rate (PDR) of 6%. Failure to control hemorrhage (67%) and failure to secure an airway (33%) were the causes of PD. Conclusion:We identified a PDR of 6% at our institution and found that a TRISS >50% correlates significantly with PD.

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“…Cost-effectiveness analysis (CEA) provides an important tool by which policymakers may assess and potentially increase the return on healthcare investments [5]. Although CEA is most useful for the evaluation of new technologies such as in knee and hip arthroplasties, there may be a place for CEA in pediatrics surgery [5,28].…”

Section: Discussionmentioning

confidence: 99%

“…Patient-centered outcomes capture the impact of a patient's overall well-being much better than traditional, surgeon-defined outcomes such as mortality or infection rates [28]. Generic health utilities have limited value in pediatric quality of care evaluation because of they are illequipped to account for the developmental changes resulting from normal growth and many are only appropriate for older children.…”

Section: Discussionmentioning

confidence: 99%

Quality Indicators in Pediatric Orthopaedic Surgery: A Systematic Review

Kennedy

Bakir

Brauer

2012

Clinical Orthopaedics &Amp; Related Research

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Background The ability to measure health system quality has become a priority for governments, the private sector, and the public. Quality indicators (QIs) refer to clear, measurable items related to outcomes. The use of QIs can initiate local quality improvement and track changes in quality over time as interventions are implemented. Questions/purposes We identified existing evidencebased indicators of quality pediatric orthopaedic care and evaluated published QIs that may be applicable to pediatric orthopaedic care. Search Strategy Using five standard search engines we searched the literature using terms such as ''quality indicators,'' ''orthopaedic surgery,'' and ''pediatric.'' Study selection was performed in a stepwise manner, first by title, then abstract, and then full-text review. Of the 604 citations identified, 13 articles were selected for inclusion. Eight papers included only pediatric patients.

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Do Pediatric Trauma Centers Have Better Survival Rates than Adult Trauma Centers? An Examination of the National Pediatric Trauma Registry

Cited by 149 publications

References 14 publications

Diffusion Tensor Imaging of the Normal Pediatric Spinal Cord Using an Inner Field of View Echo-Planar Imaging Sequence

Diffusion Tensor Imaging of the Normal Pediatric Spinal Cord Using an Inner Field of View Echo-Planar Imaging Sequence

Pediatric Mortality andPreventable Death at a Mature Trauma Center

Quality Indicators in Pediatric Orthopaedic Surgery: A Systematic Review

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