2012 Pediatric Report: Devastating at any age

The 2012 Annual Report of the National Trauma Data Bank (NTDB®) is an updated analysis of the largest aggregation of U.S. and Canadian trauma registry data ever assembled and, in fact, was the focus of this column in the January 2013 issue of the Bulletin. In total, the NTDB now contains more than 5 million records. The 2012 Annual Report is based on 773,299 records, submitted by 741 facilities, from the single admission year of 2011. This month we turn our focus to the 2012 Pediatric Report, which is based on 148,495 admission year records from 2011. The NTDB classifies pediatric patients in this report as patients who are younger than 20 years of age.

The mission of the American College of Surgeons (ACS) Committee on Trauma (COT) is to develop and implement meaningful programs for trauma care. In keeping with this mission, the NTDB is committed to being the principal national repository for trauma center data. The purpose of this report is to inform the medical community, the public, and decision makers about a variety of issues that characterize the current state of care for injured pediatric patients in the U.S. It has implications in many areas, including epidemiology, injury control, research, education, acute care, and resource allocation.

Case fatality by intent

For example, when looking at the number of incidents by intent, the overwhelming majority (greater than 88 percent) are classified as unintentional and carry a relatively low case-fatality rate of 1.28 percent. However, there is a disturbingly high case-fatality rate when it comes to the smaller group of self-inflicted injuries. Although this group accounts for approximately 1 percent of the total records, it carries the highest case-fatality rate of more than 13.5 percent. This type of information could be very useful for injury control/prevention and education because self-inflicted injuries are devastating at any age (see figure).

Many dedicated individuals on the ACS COT, including the Pediatric Surgery Subspecialty group, along with those committed to caring for pediatric patients at trauma centers across the nation, have contributed to the early development of the NTDB and its rapid growth in recent years. Building on these achievements, the goals in the coming years include improving data quality, updating analytic methods, and enabling more useful inter-hospital comparisons. These efforts will be reflected in future NTDB reports to participating hospitals as well as in the annual Pediatric Report documents.

Throughout the year, we will be highlighting these data through brief reports in the Bulletin. The National Trauma Data Bank 2012 Pediatric Report is available on the ACS website as a PDF file and a PowerPoint presentation at www.ntdb.org. In addition, information is available on the website regarding how to obtain NTDB data for more detailed study. To submit your trauma center’s data, contact Melanie L. Neal, Manager, NTDB, at mneal@facs.org.

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