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Factors Associated with Time to Arrival at a Regional Pediatric Trauma Center

Published online by Cambridge University Press:  27 November 2015

Folafoluwa O. Odetola ,
N. Clay Mann ,
Kristine W. Hansen  and
Susan L. Bratton
Folafoluwa O. Odetola*
Affiliation:
The Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor, Michigan, USA
N. Clay Mann
Affiliation:
The Department of Pediatrics, University of Utah School of Medicine, Intermountain Injury Control Research Center, Salt Lake City, Utah, USA
Kristine W. Hansen
Affiliation:
The Department of Pediatrics, University of Utah School of Medicine, Intermountain Injury Control Research Center, Salt Lake City, Utah, USA
Susan L. Bratton
Affiliation:
The Department of Pediatrics, University of Utah School of Medicine, Intermountain Injury Control Research Center, Salt Lake City, Utah, USA
*
Correspondence: Folafoluwa O. Odetola, MD, MPH 6C07, 300 North Ingalls Street Ann Arbor Michigan, USA 48109 E-mail: fodetola@med.umich.edu
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Abstract

Objective

The goal of this study was to test the hypothesis that the prehospital time between injury and arrival at a trauma center for critically injured children is associated with patient injury severity and mode of transport.

Methods

Secondary analysis of prospectively collected data on children 0-17 years of age admitted with traumatic injuries to a designated Level I pediatric trauma center from January 1, 2006 through September 30, 2007 was conducted. Multivariate regression methods were used to assess for factors independently associated with prehospital time.

Results

Of 1,175 admissions during the study period, only 355 (30%) had a prehospital time within 60 minutes of injury. Prehospital time within 60 minutes of injury was associated with higher frequency of coma, higher mean injury severity scores (ISS), and greater frequency of admission to the intensive care unit when compared with prehospital time beyond 60 minutes of injury. Children who arrived at the trauma center within 60 minutes versus beyond 60 minutes were 13-fold (odds ratio [OR]: 12.9; 95% Confidence Interval [CI], 7.6-22.0) more likely to be transported via air ambulance than a private vehicle, and had 4.8-fold greater odds (95% CI, 2.2-10.3) of transport via ground ambulance than private vehicle. For each kilometer of distance between the injury zip code and the trauma center, the odds of arrival within 60 minutes versus beyond 60 minutes decreased by 15% (OR: 0.85; 95% CI, 0.79-0.91).

Conclusion

Field triage and decision making appeared to correlate with severity of patient injury with expeditious transport of the most severely injured children to definitive trauma care. This finding serves as important groundwork that might enable further study into factors that influence triage and overall prehospital care for critically injured children.

OdetolaFO, MannNC, HansenKW, BrattonSL. Factors Associated with Time to Arrival at a Regional Pediatric Trauma Center. Prehosp Disaster Med. 2016;31(1):4–9.

Keywords

hospital chargeshospitalized childreninjurieslength of staymortality
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 1 , February 2016 , pp. 4 - 9
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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