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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

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