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Trauma Systems & Healthcare

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A Review of Racial/Ethnic Disparities in Pediatric Trauma Care, Treatment, and Outcomes
LaPlant MB, Hess DJ.
J Trauma Acute Care Surg. 2019 Mar;86(3):540-550. doi: 10.1097/TA.0000000000002160.

Rationale for inclusion: Comprehensive review of the literature on the under-studied yet highly relevant topic of racial and ethnic disparities in the care of pediatric trauma patients.

CAVEAT: Studies underlying this review are heterogenous and of mixed quality

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Do pediatric patients with trauma in Florida have reduced mortality rates when treated in designated trauma centers?
Pracht EE, Tepas JJ, Langland-Orban B, Simpson L, Pieper P, Flint LM.
J Pediatr Surg. 2008 Jan;43(1):212-21.

Rationale for inclusion: Relatively recent paper looking at a statewide registry with a large number of patients. Found that designated adult centers performed better than non-trauma centers. However, designated pediatric trauma centers performed better than adult trauma centers

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Do pediatric trauma centers have better survival rates than adult trauma centers? An examination of the National Pediatric Trauma Registry.
Osler TM, Vane DW, Tepas JJ, Rogers FB, Shackford SR, Badger GJ.
J Trauma. 2001 Jan;50(1):96-101.

Rationale for inclusion: In this look at variability between mortality rates in pediatric trauma patients between adult and pediatric trauma centers, more severely injured patients were being cared for in adult centers and mortality rate was not different when corrected for this.  Also showed a significant impact of ACS verification.

CAVEAT: This study is 15 years old, and the verification process has changed significantly.  The number of true pediatric trauma centers has grown significantly since this was published and more injured patients may now be preferentially directed to pediatric trauma centers.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Impact of pediatric trauma centers on mortality in a statewide system.
Potoka DA, Schall LC, Gardner MJ, Stafford PW, Peitzman AB, Ford HR.
J Trauma. 2000 Aug;49(2):237-45.

Rationale for inclusion: Early paper showing that adult trauma centers with added certification in pediatric trauma have better outcomes than adult trauma centers without this qualification. These differences were greatest with head, liver, and spleen injuries. 

CAVEAT: This study is 16 years old, and the verification process has changed significantly.  The defined trauma center designations no longer exist.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Influence of a statewide trauma system on pediatric hospitalization and outcome.
Hulka F, Mullins RJ, Mann NC, Hedges JR, Rowland D, Worrall WH, Sandoval RD, Zechnich A, Trunkey DD.
J Trauma. 1997 Mar;42(3):514-9.

Rationale for inclusion: A dated study, but with an interesting conclusion that prevention efforts may have a much larger impact on pediatric trauma mortality the establishment of a trauma system.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Send severely head-injured children to a pediatric trauma center.
Johnson DL, Krishnamurthy S.
Pediatr Neurosurg. 1996 Dec;25(6):309-14.

Rationale for inclusion: One of the first papers to show that particularly in children with traumatic brain injury, delivery directly to a pediatric trauma center rather than first stopping at a non-trauma center has a positive survival effect.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

The outcome for children with blunt trauma is best at a pediatric trauma center.
Hall JR, Reyes HM, Meller JL, Loeff DS, Dembek R.
J Pediatr Surg. 1996 Jan;31(1):72-6; discussion 76-7.

Rationale for inclusion: Early paper to suggest that the difference in outcome between adult and pediatric trauma centers only applies to blunt trauma patients, with little difference with respect to penetrating trauma.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Organization and function of a regional pediatric trauma center: does a system of management improve outcome?
Haller JA Jr, Shorter N, Miller D, Colombani P, Hall J, Buck J.
J Trauma. 1983 Aug;23(8):691-6.

Rationale for inclusion: One of the first papers to look at establishment of a trauma system and its beneficial effect on morbidity and mortality in pediatric trauma  patients.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

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