Citation

Stiles PJ, Helmer SD, Ward JG, Reyes J, Harrison PB, Haan JM. Am. J. Surg. 2015; 210(6): 1063-1069.

Affiliation

Department of Surgery, The University of Kansas School of Medicine - Wichita, 929 N. Saint Francis St., Room 3082, Wichita, KS 67214, USA; Department of Trauma Services, Via Christi Hospital Saint Francis, 929 N. Saint Francis St., Room 2514, Wichita, KS 67214, USA. Electronic address: James.Haan.Research@viachristi.org.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2015.08.005

PMID

26482516

Abstract

BACKGROUND: A shortage of pediatric surgeons exists. The purpose of this study was to evaluate pediatric outcomes using pediatric surgeons vs adult trauma surgeons.

METHODS: A review was conducted at 2 level II pediatric trauma centers. Center I provides 24-hour in-house trauma surgeons for resuscitations, with patient hand-off to a pediatric surgery service. Center II provides 24-hour in-house senior surgical resident coverage with an on-call trauma surgeon. Data on demographics, resource utilization, and outcomes were collected.

RESULTS: Center I patients were more severely injured (injury severity score = 8.3 vs 6.2; Glasgow coma scale score = 13.7 vs 14.3). Center I patients were more often admitted to the intensive care unit (52.2% vs 33.5%) and more often mechanically ventilated (12.9% vs 7.7%), with longer hospital length of stay (2.8 vs 2.3 days). However, mortality was not different between Center I and II (3.1% vs 2.4%). By logistic regression analyses, the only variables predictive of mortality were injury severity score and Glasgow coma scale score.

CONCLUSION: As it appears that trauma surgeons' outcomes compare favorably with those of pediatric surgeons, utilizing adult trauma surgeons may help alleviate shortages in pediatric surgeon coverage.

Language: en