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Mechanism of injury predicts case fatality and functional outcomes in pediatric trauma patients: the case for its use in trauma outcomes studies
- Source :
- Journal of Pediatric Surgery. 46:1557-1563
- Publication Year :
- 2011
- Publisher :
- Elsevier BV, 2011.
-
Abstract
- BACKGROUND/PURPOSE: The mechanism of injury (MOI) may serve as a useful adjunct to injury scoring systems in pediatric trauma outcomes research. The objective is to determine the independent effect of MOI on case fatality and functional outcomes in pediatric trauma patients. METHODS: Retrospective review of pediatric patients ages 2 to 18 years in the National Trauma Data Bank from 2002 through 2006 was done. Mechanism of injury was classified by the International Classification of Diseases, Ninth Revision, E codes. The main outcome measures were mortality, discharge disposition (home vs rehabilitation setting), and functional impairment at hospital discharge. Multiple logistic regression was used to adjust for injury severity (using the Injury Severity Score and the presence of shock upon admission in the emergency department), age, sex, and severe head or extremity injury. RESULTS: Thirty-five thousand ninety-seven pediatric patients in the National Trauma Data Bank met inclusion criteria. Each MOI had differences in the adjusted odds of death or functional disabilities as compared with the reference group (fall). The MOI with the greatest risk of death was gunshot wounds (odds ratio [OR], 3.52; 95% confidence interval [CI], 2.23-5.54 95). Pediatric pedestrians struck by a motor vehicle have the highest risk of locomotion (OR, 3.30; 95% CI, 2.89-3.77) and expression (OR, 1.65; 95% CI, 1.22-2.23) disabilities. CONCLUSION: Mechanism of injury is a significant predictor of clinical and functional outcomes at discharge for equivalently injured patients. These findings have implications for injury prevention, staging, and prognosis of traumatic injury and posttreatment planning. Language: en
- Subjects :
- Male
medicine.medical_specialty
Adolescent
Databases, Factual
medicine.medical_treatment
Poison control
Injury Severity Score
Injury prevention
Case fatality rate
Odds Ratio
medicine
Humans
Child
Retrospective Studies
Rehabilitation
business.industry
Accidents, Traffic
General Medicine
Odds ratio
Prognosis
medicine.disease
Patient Discharge
United States
Logistic Models
Child, Preschool
Pediatrics, Perinatology and Child Health
Emergency medicine
Physical therapy
Wounds and Injuries
Accidental Falls
Female
Wounds, Gunshot
Surgery
Outcomes research
business
Pediatric trauma
Subjects
Details
- ISSN :
- 00223468
- Volume :
- 46
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Surgery
- Accession number :
- edsair.doi.dedup.....d3faa9bf3d77ee9c34a62f4904a4bdd0