Comparing Major Trauma in Children and Adults in a Tertiary Trauma Centre
Authors List
Cinelli, D.P., Christchurch Hospital, Christchurch, New Zealand
D’Souza, J., Christchurch Hospital, Christchurch, New Zealand
Joyce, L., Christchurch Hospital, Christchurch, New Zealand
Wells, J., Christchurch Hospital, Christchurch, New Zealand
Introduction
Management strategies in major trauma vary between adults and children. Children may be managed in dedicated paediatric centres, adult only, or mixed hospitals. Previous studies have demonstrated increased computed tomography (CT) usage and mortality rates when being managed acutely by adult-trained professionals compared to paediatric-trained.1,2 The goal of this study is to compared the outcomes of children and adults with major trauma in a mixed adult/paediatric hospital.
Methods
This is a retrospective review of all major trauma ( injury severity score > 12) patients who presented to the emergency department (ED) of a mixed adult/paediatric hospital in a five year period (June 2016 to November 2021). Data was extracted from the hospital trauma registry and cross-referenced with electronic records. Exclusion criteria included patients transferred directly to ICU. Data was classified into subgroups adult and children ( Age > 15 and Age ≤ 15).
Results
1721 patients were identified from the trauma registry. 30 patients were excluded. 1605 adults and 86 children were identified. The most common mechanisms of injury were motor vehicle accidents (MVA) and falls ( Adults – MVA 43%, Falls 30%, Children MVA 37%, Falls 35%). 95% of adults underwent CT Imaging, median time to CT of 96 minutes and median length of stay in ED of 283 minutes. 94% of children underwent CT Imaging, median time to CT of 83 minutes and median length of stay in ED of 126 minutes. Median Overall Length of stay was 7 days in adults and 5 days in children with mortality rates of 7.8% and 6.9% respectively.
Conclusion
The study demonstrates children with major trauma in this hospital have reduced times to CT, length of stay in ED, overall length of stay, and mortality compared to adults counterparts. Further investigation is required in comparing this data at a national level.
Cinelli, D.P., Christchurch Hospital, Christchurch, New Zealand
D’Souza, J., Christchurch Hospital, Christchurch, New Zealand
Joyce, L., Christchurch Hospital, Christchurch, New Zealand
Wells, J., Christchurch Hospital, Christchurch, New Zealand
Introduction
Management strategies in major trauma vary between adults and children. Children may be managed in dedicated paediatric centres, adult only, or mixed hospitals. Previous studies have demonstrated increased computed tomography (CT) usage and mortality rates when being managed acutely by adult-trained professionals compared to paediatric-trained.1,2 The goal of this study is to compared the outcomes of children and adults with major trauma in a mixed adult/paediatric hospital.
Methods
This is a retrospective review of all major trauma ( injury severity score > 12) patients who presented to the emergency department (ED) of a mixed adult/paediatric hospital in a five year period (June 2016 to November 2021). Data was extracted from the hospital trauma registry and cross-referenced with electronic records. Exclusion criteria included patients transferred directly to ICU. Data was classified into subgroups adult and children ( Age > 15 and Age ≤ 15).
Results
1721 patients were identified from the trauma registry. 30 patients were excluded. 1605 adults and 86 children were identified. The most common mechanisms of injury were motor vehicle accidents (MVA) and falls ( Adults – MVA 43%, Falls 30%, Children MVA 37%, Falls 35%). 95% of adults underwent CT Imaging, median time to CT of 96 minutes and median length of stay in ED of 283 minutes. 94% of children underwent CT Imaging, median time to CT of 83 minutes and median length of stay in ED of 126 minutes. Median Overall Length of stay was 7 days in adults and 5 days in children with mortality rates of 7.8% and 6.9% respectively.
Conclusion
The study demonstrates children with major trauma in this hospital have reduced times to CT, length of stay in ED, overall length of stay, and mortality compared to adults counterparts. Further investigation is required in comparing this data at a national level.
