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Establishing a regional pediatric trauma preventable/potentially preventable death rate

  • Stacy A. DrakeEmail author
  • John B. Holcomb
  • Yijiong Yang
  • Caitlin Thetford
  • Lauren Myers
  • Morgan Brock
  • Dwayne A. Wolf
  • David Persse
  • Bindi J. Naik-Mathuria
  • Charles E. Wade
  • Matthew T. Harting
Original Article

Abstract

Purpose

Although trauma is the leading cause of death for the pediatric population, few studies have addressed the preventable/potentially preventable death rate (PPPDR) attributable to trauma.

Methods

This is a retrospective study of trauma-related death records occurring in Harris County, Texas in 2014. Descriptive and Chi-squared tests were conducted for two groups, pediatric and adult trauma deaths in relation to demographic characteristics, mechanism of injury, death location and survival time.

Results

There were 105 pediatric (age < 18 years) and 1738 adult patients. The PPPDR for the pediatric group was 21.0%, whereas the PPPDR for the adult group was 37.2% (p = 0.001). Analysis showed fewer preventable/potentially preventable (P/PP) deaths resulting from any blunt trauma mechanism in the pediatric population than in the adult population (19.6% vs. 48.4%, p < 0.001). Amongst the pediatric population, P/PP traumatic brain injury (TBI) were more common in the youngest age range (age 0–5) vs. the older (6–12 years) pediatric and adolescent (13–17 years) patients.

Conclusion

Our results identify areas of opportunities for improving pediatric trauma care. Although the overall P/PP death rate is lower in the pediatric population than the adult, opportunities for improving initial acute care, particularly TBI, exist.

Keywords

Pediatric trauma Mortality data Injury Trauma systems Pediatric trauma death 

Notes

Funding

The study was in part funded from two internal UTHealth sources: UTHealth Cizik School of Nursing PARTNERS Grant and Center for Translational Injury Research (CeTIR). No external funding was utilized for this manuscript. The authors have indicated they have no financial relationships relevant to this article to disclose.

Compliance with ethical standards

Conflict of interest

Dr Holcomb is the CMO of Prytime Medical, a co-founder and on the Board of Directors of Decisio Health, a Co-inventor of the Junctional Emergency Tourniquet Tool, an adviser to Terumo BCT and Arsenal Medical. All other authors’ have indicated they have no financial conflicts of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was not obtained from all individual included in the study as the data were retrospective review of decedent information contained in a pre-existing database.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Stacy A. Drake
    • 1
    Email author
  • John B. Holcomb
    • 2
  • Yijiong Yang
    • 3
  • Caitlin Thetford
    • 4
  • Lauren Myers
    • 5
  • Morgan Brock
    • 6
    • 7
  • Dwayne A. Wolf
    • 8
  • David Persse
    • 9
  • Bindi J. Naik-Mathuria
    • 4
    • 5
  • Charles E. Wade
    • 10
    • 11
  • Matthew T. Harting
    • 7
    • 11
  1. 1.Texas A&M UniversityHoustonUSA
  2. 2.University of Alabama at BirminghamBirminghamUSA
  3. 3.Cizik School of NursingThe University of Texas Health Science Center at HoustonHoustonUSA
  4. 4.Baylor College of MedicineHoustonUSA
  5. 5.Texas Children’s HospitalHoustonUSA
  6. 6.Lyndon B, Johnson General HospitalHoustonUSA
  7. 7.Children’s Memorial Hermann HospitalHoustonUSA
  8. 8.Harris County Institute of Forensic SciencesHoustonUSA
  9. 9.Department of Health & Human Services City of HoustonHoustonUSA
  10. 10.Center for Translational Injury ResearchThe University of Texas Health Science Center at HoustonHoustonUSA
  11. 11.McGovern Medical School at The University of Texas Health Science Center at HoustonHoustonUSA

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