Academic-community partnerships improve outcomes in pediatric trauma care

作者：Kelley Quon Lorraine I; Crowley Melanie A; Applebaum Harry; Cummings Katie; Kang Richard J; Tseng Chi Hong; Mangione Carol M; Shew Stephen B^*

来源：Journal of Pediatric Surgery, 2015, 50(6): 1032-1036.

DOI：10.1016/j.jpedsurg.2015.03.033

• Pediatric trauma center
• Community partnership

Background: To address the specialized needs of injured children, pediatric trauma centers (PTCs) were established at many large, academic hospitals. This study explores clinical outcomes observed for injured children treated at an academic-sponsored community facility.
Methods: In partnership with an academic medical center in a major metropolitan area, a not-for-profit community hospital became a designated Level II PTC in October 2010. Data for injured children <15 years old treated prior to PTC designation from January 2000 to September 2010 were prospectively collected using the Trauma and Emergency Medicine Information System and compared to data collected after PTC designation from January 2011 to December 2013.
Results: Overall, 681 injured children were treated at the community hospital from January 2011 to December 2013. Children treated after PTC designation were less likely to undergo computed tomography (CT) (50.9% vs. 81.3%, p < 0.01), even when controlling for age, gender, injury type, injury severity, and year (OR 0.18, 95% CI 0.08-0.37). Specifically, fewer head (45.7% vs. 68.7%, p < 0.01) and abdominal CTs (13.2% vs. 26.5%, p < 0.01) were performed. Hospital length of stay was significantly shorter (2.8 +/- 3.7 days vs. 3.7 +/- 5.9 days, p < 0.01). Mortality was low overall, but also decreased after PTC designation (0.4% vs. 2.0%, p = 0.02).
Conclusions: These results indicate that academic-community partnerships in pediatric trauma care are a feasible alternative and may lead to improved outcomes for injured children.

• 出版日期2015-6