Citation

Bozeman AP, Dassinger MS, Recicar JF, Smith SD, Rettiganti MR, Nick TG, Maxson RT. Am. J. Surg. 2012; 204(6): 933-938.

Affiliation

Division of Pediatric Surgery, Department of Surgery, University of Arkansas for Medical Sciences/Arkansas Children's Hospital, 1 Children's Way, Slot 837, Little Rock, AR 72202, USA. Electronic address: bozeman_andrew@yahoo.com.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2012.05.017

PMID

23231935

Abstract

BACKGROUND: Most trauma centers incorporate mechanistic criteria (MC) into their algorithm for trauma team activation (TTA). We hypothesized that characteristics of the crash are less reliable than restraint status in predicting significant injury and the need for TTA. METHODS: We identified 271 patients (age, <15 y) admitted with a diagnosis of motor vehicle crash. Mechanistic criteria and restraint status of each patient were recorded. Both MC and MC plus restraint status were evaluated as separate measures for appropriately predicting TTA based on treatment outcomes and injury scores. RESULTS: Improper restraint alone predicted a need for TTA with an odds ratios of 2.69 (P = .002). MC plus improper restraint predicted the need for TTA with an odds ratio of 2.52 (P = .002). In contrast, the odds ratio when using MC alone was 1.65 (P = .16). When the 5 MC were evaluated individually as predictive of TTA, ejection, death of occupant, and intrusion more than 18 inches were statistically significant. CONCLUSIONS: Improper restraint is an independent predictor of necessitating TTA in this single-institution study.

Language: en