@article{ref1,
title="Differences in survival outcome for severely injured paediatric trauma by type of trauma centre",
journal="Journal of Paediatrics and Child Health",
year="2017",
author="Mitchell, Rebecca J. and Curtis, Kate and Testa, Luke and Holland, Andrew Ja and Sv Soundappan, Soundappan and Adams, Sarah",
volume="53",
number="8",
pages="808-813",
abstract="AIM: Whether treatment at paediatric trauma centres (PTCs) provides a survival advantage for injured children over treatment at adult trauma centres (ATCs) remains inconclusive. This study examines the association between trauma centre type and in-hospital mortality for severely injured paediatric trauma patients in New South Wales, Australia. <br><br>METHODS: A retrospective examination of paediatric patient characteristics (aged ≤15 years), treatment and injury outcome was conducted using data from the New South Wales Trauma Registry for 2009-2014. Logistic regression was used to examine the association of in-hospital mortality and type of trauma centre. <br><br>RESULTS: There were 1230 children who were severely injured (i.e. Injury Severity Score; ISS > 12) and 81.0% received definitive care at a PTC. Two-thirds were male, 37.8% were aged 11-15 years and falls represented 32.0% of the injuries. Almost half (48.9%) the injured children had an ISS between 16 and 24, 31.9% between 25 and 39 and 3.8% an ISS between 40 and 75. The mean and median hospital length of stay was 17.5 and 5 days, respectively. Fifty percent of children that received definitive care at a PTC were admitted to an ICU compared to 23.9% at a Level 1 ATC. There were 119 (9.7%) in-hospital deaths. Children aged ≤15 years who were treated at a Level 1 ATC had 6.1 times higher odds of not surviving their injuries than if treated at a PTC. <br><br>CONCLUSION: Children who received definitive care at a PTC had a survival advantage compared to those treated at a Level 1 ATC. Prospectively examining the processes of care for severely injured children may assist in identification of quality and system changes required to ensure optimal trauma care within the health-care system.<br><br>© 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).<p /> <p>Language: en</p>",
language="en",
issn="1034-4810",
doi="10.1111/jpc.13514",
url="http://dx.doi.org/10.1111/jpc.13514"
}