Differences Between Pediatric & Adult Trauma Centers

There is substantial data showing pediatric trauma centers are better for young children, but evidence for the 15-19 year old age group is less clear.

A previous study looking at Ohio alone showed no difference in outcomes for 15-19 year olds whether treated at adult or pediatric trauma centers.

The Walther et al. study used the National Trauma Data Bank and included patients aged 15-19 with injury severity scores greater than 25 over a 5-year period.

The study identified almost 13,000 patients meeting the inclusion criteria, with 51% treated at adult trauma centers and 49% at pediatric trauma centers.

The patient groups at adult and pediatric trauma centers were demographically very similar without significant differences.

The median injury severity score was 33 and 45% of patients had Glasgow Coma Scale scores less than 8, indicating severe brain injuries.

There was no significant difference in mortality outcomes between adolescents treated at adult versus pediatric trauma centers.

Adolescents treated at adult trauma centers were approximately 81% more likely to have an imaging study performed compared to those at pediatric trauma centers.

Patients at pediatric trauma centers had shorter length of stay and shorter ICU length of stay compared to those at adult trauma centers.

More patients were discharged to home rather than to rehab or skilled nursing facilities when cared for at pediatric trauma centers compared to adult trauma centers.

Mortality is not the most important or reliable outcome for pediatric trauma because most children survive once they reach a hospital.

The study adds evidence that pediatric trauma centers add value for children even into the adolescent age range.

Adult trauma centers need to achieve equivalent imaging rates and lengths of stay to pediatric trauma centers for adolescents, since 51% of these patients go to adult hospitals.

Pediatric trauma centers can achieve the same outcomes with less imaging by trusting clinical diagnosis and clinical examination.

Less imaging with same outcomes and shorter length of stay proves that severely injured adolescents can be managed without unnecessary radiation exposure.