Pediatria Clínica: Acesso Aberto
Acesso livre

Abstrato

A Review of Head Trauma at Columbus Childrens Hospital: Perspectives from Pre- and Post-level 1 Trauma Center Certification

Dong Yeun Sun, Rudy Marciano, Edward J Kosnik and Chris Karas

Introduction: Historically, head trauma has accounted for a significant portion of trauma admissions to both neurosurgical services and hospitals in general. This study compares pediatric head trauma mortality at a single institution over six decades and through the transition from Level II to Level I pediatric trauma center status.

Methods: Retrospective chart review of the Columbus Children’s Hospital Trauma Registry compared pediatric head trauma data at Columbus Children’s Hospital from the following three five-year blocks, defined as periods 1, 2, and 3 respectively: 1958-1962, 1978-1982, and 2000-2004. Analysis of the data is made within each period and trends are defined with respect to diagnoses, mortality, and vulnerability of gender. Results: The following trends were noted: (1) a significant increase in major traumatic head injury admissions in Period 3 after obtaining Level I trauma center designation, (2) a significant decrease in mortality rate of major head trauma between periods 1 and 2, but no change between periods 2 and 3 and (3) early parity in head injury incidence between genders in Periods 1 and 2, with development of a significant male predominance in Period 3.

Introduction: Historically, head trauma has accounted for a significant portion of trauma admissions to both neurosurgical services and hospitals in general. This study compares pediatric head trauma mortality at a single institution over six decades and through the transition from Level II to Level I pediatric trauma center status.

Methods: Retrospective chart review of the Columbus Children’s Hospital Trauma Registry compared pediatric head trauma data at Columbus Children’s Hospital from the following three five-year blocks, defined as periods 1, 2, and 3 respectively: 1958-1962, 1978-1982, and 2000-2004. Analysis of the data is made within each period and trends are defined with respect to diagnoses, mortality, and vulnerability of gender.

Results: The following trends were noted: (1) a significant increase in major traumatic head injury admissions in Period 3 after obtaining Level I trauma center designation, (2) a significant decrease in mortality rate of major head trauma between periods 1 and 2, but no change between periods 2 and 3 and (3) early parity in head injury incidence between genders in Periods 1 and 2, with development of a significant male predominance in Period 3.

Conclusion: Transitioning from Level II to Level I pediatric trauma center status correlated with a significant increase in pediatric head trauma admissions in this particular market. Although there have been significant decreases in mortality secondary to head trauma for various reasons between 1958 and 1978, there has been little change between 1978 and 2004 at the facility being studied despite transitioning from a Level II to Level I pediatric trauma center during that time period. There was a significant male predominance to sustain head trauma as compared to females in the most recent time period.

Transitioning from Level II to Level I pediatric trauma center status correlated with a significant increase in pediatric head trauma admissions in this particular market. Although there have been significant decreases in mortality secondary to head trauma for various reasons between 1958 and 1978, there has been little change between 1978 and 2004 at the facility being studied despite transitioning from a Level II to Level I pediatric trauma center during that time period. There was a significant male predominance to sustain head trauma as compared to females in the most recent time period.