2014 Pediatric Report: How severe is it?

The 2014 Pediatric Report of the National Trauma Data Bank® (NTDB®) is an updated analysis of the largest aggregation of U.S./Canadian trauma registry data ever assembled. In total, the NTDB now contains more than 6 million records. The 2014 Annual Report is based on 814,663 records submitted by 758 facilities from the single admission year of 2013. The 2014 Pediatric Report is based on 141,067 records from the single admission year of 2013. The NTDB classifies pediatric patients in this report as patients that are younger than 20 years of age.

Annual Pediatric Report

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 registry data. The purpose of this particular 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 our country. It has implications in many areas, including epidemiology, injury control, research, education, acute care, and resource allocation.

More than half (58.9 percent) of the 756 facilities that submitted data for the 2014 Pediatric Report are not affiliated with a pediatric hospital. The remaining 311 facilities (41.1 percent) are associated with a children’s hospital. Another 32 facilities are further characterized as pediatric-only, including 26 pediatric Level I and six pediatric Level II trauma centers. In total, 65 percent of the reporting facilities have a pediatric ward, and 33 percent have a pediatric intensive care unit. Almost three-fourths (74 percent) of the facilities transfer severely injured patients to other medical centers (see Figures 1 and 2).

Figure 1. Facilities by pediatric hospital association

Figure 1. Facilities by pediatric hospital association

Figure 2. Case fatality rate by injury severity scoreFigure 2. Case fatality rate by Injury Severity Score

Developing better data

Many dedicated members of the ACS COT, including those surgeons who serve on the Pediatric Surgery Subspecialty group, along with dedicated individuals caring for pediatric patients at trauma centers around the country, 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 developing processes that allow users to draw more useful comparisons from hospital to hospital. The results of these efforts will be reflected in future NTDB reports to participating hospitals, as well as in annual pediatric reports.

Throughout the year, we will be highlighting these and other trauma data through brief reports published monthly in the Bulletin. The 2014 NTDB Pediatric Report is available on the ACS website.

In addition, information is available on the NTDB Web page about how to obtain NTDB data for more detailed study. If you are interested in submitting your trauma center’s data, contact Melanie L. Neal, Manager, NTDB at mneal@facs.org.

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