Ten-Year Retrospective Study of Delayed Diagnosis of Injury in Pediatric Trauma Patients at a Level II Trauma Center

2009 ◽  
Vol 25 (8) ◽  
pp. 489-493 ◽  
Author(s):  
Benjamin G. Williams ◽  
Thein Hlaing ◽  
Mary O. Aaland
Keyword(s):  
Retrospective Study ◽  
Trauma Center ◽  
Pediatric Trauma ◽  
Delayed Diagnosis ◽  
Trauma Patients ◽  
Level Ii

Laparoscopy in the Evaluation of Blunt Abdominal Injury in Level-I and II Pediatric Trauma Centers

2022 ◽  
pp. 000313482110335
Author(s):  
Aryan Haratian ◽  
Areg Grigorian ◽  
Karan Rajalingam ◽  
Matthew Dolich ◽  
Sebastian Schubl ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Trauma Center ◽  
Injury Severity ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Improvement Program ◽  
Blunt Abdominal Injury ◽  
Level Ii ◽  
American College Of Surgeons ◽  
Level I

Introduction An American College of Surgeons (ACS) Level-I (L-I) pediatric trauma center demonstrated successful laparoscopy without conversion to laparotomy in ∼65% of trauma cases. Prior reports have demonstrated differences in outcomes based on ACS level of trauma center. We sought to compare laparoscopy use for blunt abdominal trauma at L-I compared to Level-II (L-II) centers. Methods The Pediatric Trauma Quality Improvement Program was queried (2014-2016) for patients ≤16 years old who underwent any abdominal surgery. Bivariate analyses comparing patients undergoing abdominal surgery at ACS L-I and L-II centers were performed. Results 970 patients underwent abdominal surgery with 14% using laparoscopy. Level-I centers had an increased rate of laparoscopy (15.6% vs 9.7%, P = .019 ); however they had a lower mean Injury Severity Score (16.2 vs 18.5, P = .002) compared to L-II centers. Level-I and L-II centers had similar length of stay ventilator days, and SSIs (all P > .05). Conclusion While use of laparoscopy for pediatric trauma remains low, there was increased use at L-I compared to L-II centers with no difference in LOS or SSIs. Future studies are needed to elucidate which pediatric trauma patients benefit from laparoscopic surgery.

Delayed Diagnosis of Injury in Pediatric Trauma Patients at a Level I Trauma Center

2021 ◽  
Author(s):  
Geoffrey Lowe ◽  
Jefferson Tweed ◽  
Michael Cooper ◽  
Faisal Qureshi ◽  
Craig Huang
Keyword(s):  
Trauma Center ◽  
Pediatric Trauma ◽  
Delayed Diagnosis ◽  
Trauma Patients ◽  
Level I

scholarly journals Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Anne K. Misiura ◽  
Autumn D. Nanassy ◽  
Jacqueline Urbine
Keyword(s):  
Trauma Center ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Additional Information ◽  
Pelvic Radiographs ◽  
Pelvic Radiograph ◽  
Digital Radiograph ◽  
Urban Level ◽  
Level I ◽  
Pediatric Trauma Center

Trauma patients in a Level I Pediatric Trauma Center may undergo CT of the abdomen and pelvis with concurrent radiograph during initial evaluation in an attempt to diagnose injury. To determine if plain digital radiograph of the pelvis adds additional information in the initial trauma evaluation when CT of the abdomen and pelvis is also performed, trauma patients who presented to an urban Level I Pediatric Trauma Center between 1 January 2010 and 7 February 2017 in whom pelvic radiograph and CT of the abdomen and pelvis were performed within 24 hours of each other were analyzed. A total of 172 trauma patients had pelvic radiograph and CT exams performed within 24 hours of each other. There were 12 cases in which the radiograph missed pelvic fractures seen on CT and 2 cases in which the radiograph suspected a fracture that was not present on subsequent CT. Furthermore, fractures in the pelvis were missed on pelvic radiographs in 12 of 35 cases identified on CT. Sensitivity of pelvic radiograph in detecting fractures seen on CT was 65.7% with a 95% confidence interval of 47.79-80.87%. Results suggest that there is no added diagnostic information gained from a pelvic radiograph when concurrent CT is also obtained, a practice which exposes the pediatric trauma patient to unnecessary radiation.

Pediatric Trauma Deaths: A Three-Part Analysis from a Nonacademic Trauma Center

2006 ◽  
Vol 72 (3) ◽  
pp. 249-259
Author(s):  
Mary O. Aaland ◽  
Thein Hlaing
Keyword(s):  
Mortality Rate ◽  
Trauma Center ◽  
Pediatric Trauma ◽  
Trauma System ◽  
Time Frame ◽  
Level Ii ◽  
Liver Injuries ◽  
Depth Analysis ◽  
Trauma Mortality ◽  
Trauma Deaths

A three-part analysis was undertaken to assess pediatric trauma mortality in a nonacademic Level II trauma center at Parkview Hospital in Fort Wayne, Indiana. Part I was a comparison of Parkview trauma registry data collected from 1999 through 2003 with those of pediatric and adult trauma centers in Pennsylvania. The same methodology used in Pennsylvania was used for the initial evaluation of pediatric deaths from trauma in our trauma center. Part II was a formal in-depth analysis of all individual pediatric deaths as well as surgical cases with head, spleen, and liver injuries from the same time frame. Part III proposes a new methodology to calculate a risk-adjusted mortality rate based on the TRISS model for the evaluation of a trauma system. The use of specific mortality and surgical intervention rates was not an accurate reflection of trauma center outcome. The proposed risk-adjusted mortality rate calculation is perhaps an effective outcome measure to assess patient care in a trauma system.

Incidence of Delayed Diagnosis of Orthopaedic Injury in Pediatric Trauma Patients

2017 ◽  
Vol 31 (9) ◽  
pp. e281-e287
Author(s):  
Jeremy D. Podolnick ◽  
Daniel S. Donovan ◽  
Alfred W. Atanda
Keyword(s):  
Pediatric Trauma ◽  
Delayed Diagnosis ◽  
Trauma Patients ◽  
Orthopaedic Injury

A Multidisciplinary Approach to Adverse Drug Events in Pediatric Trauma Patients in an Adult Trauma Center

2009 ◽  
Vol 25 (7) ◽  
pp. 444-446 ◽  
Author(s):  
Michael Kalina ◽  
Glen Tinkoff ◽  
Wendy Gleason ◽  
Paula Veneri ◽  
Gerard Fulda
Keyword(s):  
Trauma Center ◽  
Multidisciplinary Approach ◽  
Adverse Drug Events ◽  
Pediatric Trauma ◽  
Trauma Patients

scholarly journals CT Use in Hospitalized Pediatric Trauma Patients: 15-year Trends in a Level I Pediatric and Adult Trauma Center

Radiology ◽  
2013 ◽  
Vol 267 (2) ◽  
pp. 479-486 ◽  
Author(s):  
Bahman S. Roudsari ◽  
Kevin J. Psoter ◽  
Monica S. Vavilala ◽  
Christopher D. Mack ◽  
Jeffrey G. Jarvik
Keyword(s):  
Trauma Center ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Level I
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