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Table 1 Patient and injury characteristics of pediatric severe TBI patient visits treated in ATC-AQs and ATCs

From: Outcomes of pediatric severe traumatic brain injury patients treated in adult trauma centers with and without added qualifications in pediatrics — United States, 2009

 

ATC-AQ

ATC

Total

Odds Ratio *(95% CI)

P value *

n (%)

n (%)

n (%)

(N = 3,496)

(N = 3,561)

(N = 7,057)

Sex

     

 Female

1,215 (34.8)

1,144 (32.1)

2,359 (33.4)

1.0 (reference)

 

 Male

2,281 (65.2)

2,417 (67.9)

4,698 (66.6)

0.889 (0.805–0.981)

0.0202

Age group (years)

     

 0–3

1,154 (33.0)

681 (19.1)

1,835 (26.0)

1.0 (reference)

 

 4–8

604 (17.3)

426 (12.0)

1,030 (14.6)

0.837 (0.716–0.978)

0.0279

 9–13

618 (17.7)

539 (15.1)

1,157 (16.4)

0.677 (0.583–0.786)

<.0001

 14–17

1,120 (32.0)

1,915 (53.8)

3,035 (43.0)

0.345 (0.306–0.389)

<.0001

Race/Ethnicity

     

 White

1,895 (54.2)

2,027 (56.9)

3,922 (55.6)

1.0 (reference)

 

 Black

606 (17.3)

500 (14.0)

1,106 (15.7)

1.296 (1.134–1.482)

0.0002

 Hispanic

622 (17.8)

648 (18.2)

1,270 (18.0)

1.027 (0.905–1.165)

0.6983

 Other

259 (7.4)

251 (7.0)

510 (7.2)

1.104 (0.918–1.327)

0.3005

 Unknown

114 (3.3)

135 (3.8)

249 (3.5)

0.903 (0.699–1.168)

0.4720

Insurance

     

 Commercial and other

1,709 (48.9)

1,941 (54.5)

3,650 (51.7)

1.0 (reference)

 

 Self Pay

233 (6.7)

314 (8.8)

547 (7.8)

0.843 (0.703–1.011)

0.0660

 Medicaid

1,047 (29.9)

925 (26.0)

1,972 (27.9)

1.286 (1.152–1.435)

<.0001

 Unknown

507 (14.5)

381 (10.7)

888 (12.6)

1.511 (1.304–1.752)

<.0001

Trauma center level

     

 Level I

2,482 (71.0)

2,228 (62.6)

4,710 (66.7)

1.0 (reference)

 

 Level II

1,014 (29.0)

1,333 (37.4)

2,347 (33.3)

0.683 (0.618–0.754)

<.0001

ED GCS

     

 3–4

670 (19.2)

714 (20.1)

1,384 (19.6)

0.913 (0.81–1.028)

0.1361

 5–6

94 (2.7)

135 (3.8)

229 (3.2)

0.677 (0.518–0.887)

0.0045

 7–8

111 (3.2)

156 (4.4)

267 (3.8)

0.692 (0.539–0.889)

0.0038

 >8

2,499 (71.5)

2,431 (68.3)

4,930 (69.9)

1.0 (reference)

 

 Unknown

122 (3.5)

125 (3.5)

247 (3.5)

0.949 (0.735–1.226)

0.6962

Head AIS

     

 3

1,125 (32.2)

1,162 (32.6)

2,287 (32.4)

1.0 (reference)

 

 4

2,021 (57.8)

1,873 (52.6)

3,894 (55.2)

1.115 (1.005–1.236)

0.0399

 5

345 (9.9)

515 (14.5)

860 (12.2)

0.692 (0.590–0.811)

<.0001

 6

5 (0.1)

11 (0.3)

16 (0.2)

0.469 (0.163–1.356)

0.2098

ISS Score

     

 ISS < 15

847 (24.2)

875 (24.6)

1,722 (24.4)

1.0 (reference)

 

 ISS > 15

2,329 (66.6)

2,378 (66.8)

4,707 (66.7)

1.012 (0.906–1.130)

0.8437

 Unknown

320 (9.2)

308 (8.6)

628 (8.9)

1.073 (0.894–1.289)

0.4560

Mechanism of injury

     

 Falls

1,028 (29.4)

858 (24.1)

1,886 (26.7)

1.0 (reference)

 

 Firearms

108 (3.1)

185 (5.2)

293 (4.2)

0.487 (0.378–0.628)

<.0001

 Motor vehicles

1,303 (37.3)

1,433 (40.2)

2,736 (38.8)

0.759 (0.675–0.854)

<.0001

 Struck by/against

328 (9.4)

407 (11.4)

735 (10.4)

0.673 (0.567–0.798)

<.0001

 Other

728 (20.8)

678 (19.0)

1,406 (19.9)

0.896 (0.780–1.029)

0.1289

 Unknown

1 (0.0)

0 (0.0)

1 (0.0)

  

TBI type

     

 SAH, SDH, EDH

811 (23.2)

788 (22.1)

1,599 (22.7)

1.171 (1.036–1.325)

0.0121

 Intracranial Hemm (other and unspecified)

107 (3.1)

122 (3.4)

229 (3.2)

0.998 (0.762–1.308)

1.0000

 Cerebral Laceration and Contusion

246 (7.0)

260 (7.3)

506 (7.2)

1.077 (0.891–1.302)

0.4680

 Other Intracranial Injury

169 (4.8)

118 (3.3)

287 (4.1)

1.630 (1.274–2.086)

0.0001

 No Mention of Intracranial Injury

853 (24.4)

782 (22.0)

1,635 (23.2)

1.242 (1.099–1.403)

0.0005

 Other

1,310 (37.5)

1,491 (41.9)

2,801 (39.7)

1.0 (reference)

 

Presence of severe TBI polytrauma †

     

 TBI only

1,265 (36.2)

1,140 (32.0)

2,405 (34.1)

1.0 (reference)

 

 TBI + non–Severe Injury

1,500 (42.9)

1,580 (44.4)

3,080 (43.6)

0.856 (0.769–0.952)

0.0043

 TBI + Severe Injury

731 (20.9)

841 (23.6)

1,572 (22.3)

0.783 (0.690–0.890)

0.0002

Hospital complications ‡

     

 No

1,716 (49.1)

1,448 (40.7)

3,164 (44.8)

1.0 (reference)

 

 Yes

333 (9.5)

423 (11.9)

756 (10.7)

0.664 (0.566–0.779)

<.0001

 Unknown

1,447 (41.4)

1,690 (47.5)

3,137 (44.5)

0.722 (0.654–0.798)

<.0001

Discharge disposition §

     

 Home (without extra care)

2,621 (82.0)

2,382 (74.6)

5,003 (78.3)

1.0 (reference)

 

 Rehabilitation/other care facility

512 (16.0)

674 (21.1)

1,186 (18.6)

0.690 (0.608–0.784)

<.0001

 Other/unknown

64 (2.0)

139 (4.4)

203 (3.2)

0.418 (0.310–0.566)

<.0001

ICU Days (Mean ± SE)

4.84 (0.16)

5.01 (0.17)

4.93 (0.12)

 

0.4684**

Length of stay (days) (Mean ± SE)

6.17 (0.16)

6.09 (0.17)

6.13 (0.12)

 

0.7369**

 Alive (Mean ± SE)

6.40 (0.17)

6.44 (0.19)

6.42 (0.13)

 

0.8665**

 Died (Mean ± SE)

3.73 (0.4)

3.04 (0.27)

3.35 (0.23)

 

0.1574**

Ventilator days (Mean ± SE)

6.09 (0.29)

5.57 (0.26)

5.81 (0.19)

 

0.1728**

Mortality

299 (8.6)

366 (10.3)

665 (9.4)

0.816 (0.695–0.959)

0.0144

  1. Data are reported as counts, percentages (%), and mean + SE.
  2. *Calculated by χ2 test; **Calculated by two-tailed independent t-test.
  3. †Non-severe polytraumatic TBI = severe TBI plus injury in body region other than head with AIS score < 3, severe polytraumatic TBI = severe TBI plus injury in body region other than head with AIS score ≥3.
  4. ‡Defined by NTDB as any medical complication occurring during hospital stay.
  5. §Disposition does not include deaths (n = 665).
  6. Other care facilities include short-, long-, and intermediate-care facilities, home with home health services/extra care, and hospice.
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Injury Epidemiology

ISSN: 2197-1714