Trauma Experts Versus Pediatric Experts – Comparison of Outcomes in Pediatric Penetrating Injuries

Abstract Background While pediatric trauma centers (PTCs) can uniquely care for pediatric patients, adult trauma centers (ATCs) may be more accessible. Evidence is scarce regarding outcomes of pediatric patients with penetrating trauma treated at PTCs versus ATCs. Materials and Methods We performed a retrospective study utilizing the National Trauma Data Bank (NTDB) to identify pediatric patients age ≤18 years with penetrating injuries from 2007 through 2012, treated at stand-alone PTCs or ATCs. We excluded patients treated at combined pediatric/adult trauma centers, transferred between hospitals, with gunshot wounds to the head, or dead on arrival. Eligible patients numbered 26,276 (PTC n=3,737; ATC n=22,539). The primary outcome was in-hospital mortality. The secondary outcome was discharge location as a potential surrogate for functional outcome. Univariate and multivariate analyses assessed trauma center type as an independent risk factor for outcomes. Results Patients treated at ATCs were more likely to have Injury Severity Score (ISS) >15, Glasgow Coma Scale (GCS)