For injured adolescents, odds of mortality higher for those treated at adult, mixed trauma centers
TUESDAY, July 5, 2016 (HealthDay News) — For injured adolescents, treatment at pediatric trauma centers (PTCs) is associated with lower mortality compared with treatment at adult trauma centers (ATCs) or mixed trauma centers (MTCs) that treat both pediatric and adult trauma patients, according to a study published online June 27 in JAMA Pediatrics.
Rachel B. Webman, M.D., from the Children’s National Medical Center in Washington, D.C., and colleagues used a national data set to compare mortality of injured adolescents treated at ATCs, PTCs, or MTCs. Multilevel models accounting for center-specific effects were used to assess the correlation of center characteristics on mortality among patients aged 15 to 19 years with a blunt or penetrating injury.
The researchers found that 68.9 percent of the 29,613 injured adolescents were treated at ATCs, 25.6 percent at MTCs, and 5.5 percent at PTCs. Compared with those treated at ATCs or MTCs, adolescents treated at PTCs were more likely to be injured by a blunt than penetrating mechanism (91.4 versus 80.4 or 84.6 percent, respectively). Adolescents treated at ATCs and MTCs had higher mortality than those treated at PTCs (3.2 and 3.5 percent, respectively, versus 0.4 percent; P < 0.001). Compared with PTCs, the adjusted odds of mortality were higher at ATCs and MTCs (odds ratios, 4.19 and 6.68, respectively).
“Defining resource and patient features that account for these observed differences is needed to optimize adolescent outcomes after injury,” the authors write.
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