Citation

Dixon MD, Engum S. Am. Surg. 2019; 85(11): 1281-1287.

Copyright

(Copyright © 2019, Southeastern Surgical Congress)

DOI

unavailable

PMID

31775972

Abstract

ACS-verified trauma centers show higher survival and improved mortality rates in states with ACS-verified Level I pediatric trauma centers. However, few significant changes are appreciated in the first two years after verification. Minimal research exists examining verification of ACS Level II pediatric trauma centers. We analyzed ACS Level II pediatric trauma verification at our institution. In 2014, Sanford Medical Center Fargo became the only Level II pediatric trauma center in North Dakota, as well as the only center between Spokane and Minneapolis. A retrospective review of the institution's pre-existing trauma database one year pre- and postverification was performed. Patients aged <18 years were included in the study (P < 0.05). Patient number increased by 23 per cent, from 167 to 205 patients. A statistically significant increase occured in the three to six year old age group (P = 0.0002); motorized recreational vehicle (P = 0.028), violent (P = 0.009), and other (P = 0.0374) mechanism of injury categories; ambulance (P = 0.0124), fixed wing (P = 0.0028), and personal-owned vehicle (P = 0.0112) modes of transportation. Decreased public injuries (P = 0.0071) and advanced life support ambulance transportation (P = 0.0397). The study showed a nonstatistically significant increase in mean Injury Severity Score (from 6.3 to 7) and Native American trauma (from 14 to 20 per cent). Whereas prolonged ACS Level I pediatric trauma center verification was found to benefit patients, minimal data exist on ACS Level II verification. Our findings are consistent with current Level I ACS pediatric trauma center data. Future benefits will require continued analysis because our Level II pediatric trauma center continues to mature and affect our rural and large Native American community.

Language: en