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Variation in patterns of hospitalization and associated resource use among children with spinal cord injury in the U.S.
Injury. 2016 May; 47(5):1123-7.I

Abstract

INTRODUCTION

Trauma is a leading cause of mortality and morbidity among children in the U.S. There is paucity of data on the triage of children with spinal cord injury (SCI) to definitive trauma care, and it is unknown if clinical outcomes and resource utilization for children hospitalized with SCI vary according to the settings where trauma care is provided. The study was conducted to describe recent patterns of emergency department (ED) evaluation for paediatric SCI in the U.S., and to characterize outcomes and resource use for children hospitalized at non-trauma centres versus trauma centres.

MATERIALS AND METHODS

Secondary analysis of a national database on injured children 0-20 years evaluated at U.S. EDs and either hospitalized or released, in 2009-2012. In-hospital mortality, duration of stay, and overall charges, were compared according to trauma centre status of the treating hospital.

RESULTS

Of an estimated 67 million annual paediatric visits to the ED for trauma evaluation nationally in 2009-2012, 2317 had SCI. Majority (87%) of children evaluated for SCI were under 6 years of age, and boys comprised 73% of the visits. Injuries were caused mainly by motor vehicle accidents, falls, non-transport-related accidents, and firearms. The South census region had the most ED visits and hospitalizations. Majority (92%) of the most severely injured was evaluated at trauma centres, and more visits to trauma centres (81% vs. 18%, p=0.022) resulted in hospitalization. Among an estimated 1570 hospitalizations of children with SCI from the ED nationally, children at trauma centres were more likely to have major injuries (67% vs. 44%, p=0.001), similar mortality, longer average hospital stay, and higher charges, compared with children hospitalized at non-trauma centres.

CONCLUSION

Significant demographic and geographical variation exists in national patterns of hospital care for paediatric SCI. Higher severity of patient injury was associated with concomitantly higher hospital resource use at trauma centres.

Authors+Show Affiliations

Department of Pediatrics and Communicable Diseases, Division of Pediatric Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI 48109, USA; Department of Pediatrics and Communicable Diseases, Child Health Evaluation and Research Unit, University of Michigan Health System, Ann Arbor, MI 48109, USA. Electronic address: fodetola@med.umich.edu.Department of Pediatrics and Communicable Diseases, Child Health Evaluation and Research Unit, University of Michigan Health System, Ann Arbor, MI 48109, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26861801

Citation

Odetola, Folafoluwa O., and Achamyeleh Gebremariam. "Variation in Patterns of Hospitalization and Associated Resource Use Among Children With Spinal Cord Injury in the U.S." Injury, vol. 47, no. 5, 2016, pp. 1123-7.
Odetola FO, Gebremariam A. Variation in patterns of hospitalization and associated resource use among children with spinal cord injury in the U.S. Injury. 2016;47(5):1123-7.
Odetola, F. O., & Gebremariam, A. (2016). Variation in patterns of hospitalization and associated resource use among children with spinal cord injury in the U.S. Injury, 47(5), 1123-7. https://doi.org/10.1016/j.injury.2016.01.031
Odetola FO, Gebremariam A. Variation in Patterns of Hospitalization and Associated Resource Use Among Children With Spinal Cord Injury in the U.S. Injury. 2016;47(5):1123-7. PubMed PMID: 26861801.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Variation in patterns of hospitalization and associated resource use among children with spinal cord injury in the U.S. AU - Odetola,Folafoluwa O, AU - Gebremariam,Achamyeleh, Y1 - 2016/02/01/ PY - 2015/10/02/received PY - 2015/12/22/revised PY - 2016/01/23/accepted PY - 2016/2/11/entrez PY - 2016/2/11/pubmed PY - 2017/9/12/medline KW - Hospital charges KW - Hospitalization KW - Length of stay KW - Mortality KW - Spinal cord injuries SP - 1123 EP - 7 JF - Injury JO - Injury VL - 47 IS - 5 N2 - INTRODUCTION: Trauma is a leading cause of mortality and morbidity among children in the U.S. There is paucity of data on the triage of children with spinal cord injury (SCI) to definitive trauma care, and it is unknown if clinical outcomes and resource utilization for children hospitalized with SCI vary according to the settings where trauma care is provided. The study was conducted to describe recent patterns of emergency department (ED) evaluation for paediatric SCI in the U.S., and to characterize outcomes and resource use for children hospitalized at non-trauma centres versus trauma centres. MATERIALS AND METHODS: Secondary analysis of a national database on injured children 0-20 years evaluated at U.S. EDs and either hospitalized or released, in 2009-2012. In-hospital mortality, duration of stay, and overall charges, were compared according to trauma centre status of the treating hospital. RESULTS: Of an estimated 67 million annual paediatric visits to the ED for trauma evaluation nationally in 2009-2012, 2317 had SCI. Majority (87%) of children evaluated for SCI were under 6 years of age, and boys comprised 73% of the visits. Injuries were caused mainly by motor vehicle accidents, falls, non-transport-related accidents, and firearms. The South census region had the most ED visits and hospitalizations. Majority (92%) of the most severely injured was evaluated at trauma centres, and more visits to trauma centres (81% vs. 18%, p=0.022) resulted in hospitalization. Among an estimated 1570 hospitalizations of children with SCI from the ED nationally, children at trauma centres were more likely to have major injuries (67% vs. 44%, p=0.001), similar mortality, longer average hospital stay, and higher charges, compared with children hospitalized at non-trauma centres. CONCLUSION: Significant demographic and geographical variation exists in national patterns of hospital care for paediatric SCI. Higher severity of patient injury was associated with concomitantly higher hospital resource use at trauma centres. SN - 1879-0267 UR - https://www.unboundmedicine.com/medline/citation/26861801/Variation_in_patterns_of_hospitalization_and_associated_resource_use_among_children_with_spinal_cord_injury_in_the_U_S_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0020-1383(16)00053-X DB - PRIME DP - Unbound Medicine ER -