TY  - JOUR
T1  - SOurce of admission and outcomes for critically injured children in the mountain states
AU  - Odetola FO, Mann N, Hansen KW, Patrick S, Bratton SL
Y1  - 2010/03/01
N1  - 10.1001/archpediatrics.2009.285
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 277
EP  - 282
VL  - 164
IS  - 3
N2  - Objective 
    To determine whether mortality and length of stay at a pediatric trauma center differ between patients admitted by interhospital transfer and those admitted directly from the injury scene.Design 
    Analysis of prospectively collected data from a pediatric trauma center database.Setting 
    A designated regional level I pediatric trauma center.Participants 
    Injured children from birth to 17 years of age hospitalized between January 1, 2006, and September 30, 2007.Main Exposure 
    Incident in-hospital mortality rates and length of stay at the trauma center were compared between patients admitted directly and those admitted by interhospital transfer, controlling for potential confounders.Outcome Measures 
    In-hospital mortality and duration of hospitalization.Results 
    Of 2192 patients admitted to the trauma center, 1175 (53.6%) were admitted directly from the injury scene. Patients admitted by interhospital transfer had higher injury severity and lower Glasgow Coma Scale scores at admission (P < .01). Of 31 deaths during the study period, 26 (83.9%) were among patients admitted by interhospital transfer. These patients had a 7-fold higher unadjusted incident rate of death (incidence rate ratio, 7.16; 95% confidence interval, 2.49-20.58) compared with those admitted directly. This finding remained (incidence rate ratio, 3.01; 95% confidence interval, 1.01-8.98) after adjustment for injury severity and Glasgow Coma Scale scores, elapsed time from injury until admission at the trauma center, and age. Among survivors, patients admitted by interhospital transfer stayed longer in the hospital than those admitted directly.Conclusion 
    Pediatric trauma center mortality rates are lower among children admitted directly from the injury scene compared with those admitted by interhospital transfer.
SN  - 1072-4710
M3  - doi: 10.1001/archpediatrics.2009.285
UR  - http://dx.doi.org/10.1001/archpediatrics.2009.285
ER  -