Effects of establishing a trauma center on the mortality rate among injured pediatric patients in Japan.
INTRODUCTION:It remains unclear whether trauma centers are effective for the treatment of injured pediatric patients. The aim of this study was to evaluate children's mortality before and after the establishment a trauma center by using standard mortality ratios (SMR) and a modified observed-ex...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0217140 |
| _version_ | 1818682423526817792 |
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| author | Takashi Muguruma Chiaki Toida Masayasu Gakumazawa Naoki Yogo Mafumi Shinohara Ichiro Takeuchi |
| author_facet | Takashi Muguruma Chiaki Toida Masayasu Gakumazawa Naoki Yogo Mafumi Shinohara Ichiro Takeuchi |
| author_sort | Takashi Muguruma |
| collection | DOAJ |
| description | INTRODUCTION:It remains unclear whether trauma centers are effective for the treatment of injured pediatric patients. The aim of this study was to evaluate children's mortality before and after the establishment a trauma center by using standard mortality ratios (SMR) and a modified observed-expected chart. METHODS:This was a single center, retrospective chart review study that included injured pediatric patients (age <16 years) who were transported to our trauma center by the emergency medical services from 2012 to 2016 in Japan. RESULTS:Our study included 143 subjects: 45 (31%) were preschoolers aged < 6 years, and 43 (30%) had an injury severity score (ISS) ≥ 16. After the trauma centers established, the number of patients increased (70% increase per month), as did the number of the patients with an ISS of 41-75. The percentage of indirect transportations was significantly higher in the trauma center than in the non-trauma center (49% vs. 28%; p < 0.05). The SMR was significantly lower in the trauma-center than in the non-trauma center (0.461 vs. 0.589; p < 0.05). The mean value of the modified observed-expected chart was significantly higher in the trauma-center than in the non-trauma center (4.6 vs. 2.3; p < 0.05). For the patients who were directly transferred to our center, the transfer distance was greater in the trauma-center than in the non-trauma center (6.8 vs. 6.2 km; p < 0.05). The time interval from hospital admission to initiation of computed tomography (15.5 vs. 33 minutes; p < 0.05) and to definitive care (44 vs. 64.5 minutes; p < 0.05) decreased in the after group compared to the non-trauma center. CONCLUSIONS:The results of our study revealed that the centralization of pediatric injured pediatric patients in trauma centers improved the mortality rate in this population in Japan. |
| first_indexed | 2024-12-17T10:18:36Z |
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| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-17T10:18:36Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-b08e37811bf24db0ba982daf8d103dcb2022-12-21T21:52:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01145e021714010.1371/journal.pone.0217140Effects of establishing a trauma center on the mortality rate among injured pediatric patients in Japan.Takashi MugurumaChiaki ToidaMasayasu GakumazawaNaoki YogoMafumi ShinoharaIchiro TakeuchiINTRODUCTION:It remains unclear whether trauma centers are effective for the treatment of injured pediatric patients. The aim of this study was to evaluate children's mortality before and after the establishment a trauma center by using standard mortality ratios (SMR) and a modified observed-expected chart. METHODS:This was a single center, retrospective chart review study that included injured pediatric patients (age <16 years) who were transported to our trauma center by the emergency medical services from 2012 to 2016 in Japan. RESULTS:Our study included 143 subjects: 45 (31%) were preschoolers aged < 6 years, and 43 (30%) had an injury severity score (ISS) ≥ 16. After the trauma centers established, the number of patients increased (70% increase per month), as did the number of the patients with an ISS of 41-75. The percentage of indirect transportations was significantly higher in the trauma center than in the non-trauma center (49% vs. 28%; p < 0.05). The SMR was significantly lower in the trauma-center than in the non-trauma center (0.461 vs. 0.589; p < 0.05). The mean value of the modified observed-expected chart was significantly higher in the trauma-center than in the non-trauma center (4.6 vs. 2.3; p < 0.05). For the patients who were directly transferred to our center, the transfer distance was greater in the trauma-center than in the non-trauma center (6.8 vs. 6.2 km; p < 0.05). The time interval from hospital admission to initiation of computed tomography (15.5 vs. 33 minutes; p < 0.05) and to definitive care (44 vs. 64.5 minutes; p < 0.05) decreased in the after group compared to the non-trauma center. CONCLUSIONS:The results of our study revealed that the centralization of pediatric injured pediatric patients in trauma centers improved the mortality rate in this population in Japan.https://doi.org/10.1371/journal.pone.0217140 |
| spellingShingle | Takashi Muguruma Chiaki Toida Masayasu Gakumazawa Naoki Yogo Mafumi Shinohara Ichiro Takeuchi Effects of establishing a trauma center on the mortality rate among injured pediatric patients in Japan. PLoS ONE |
| title | Effects of establishing a trauma center on the mortality rate among injured pediatric patients in Japan. |
| title_full | Effects of establishing a trauma center on the mortality rate among injured pediatric patients in Japan. |
| title_fullStr | Effects of establishing a trauma center on the mortality rate among injured pediatric patients in Japan. |
| title_full_unstemmed | Effects of establishing a trauma center on the mortality rate among injured pediatric patients in Japan. |
| title_short | Effects of establishing a trauma center on the mortality rate among injured pediatric patients in Japan. |
| title_sort | effects of establishing a trauma center on the mortality rate among injured pediatric patients in japan |
| url | https://doi.org/10.1371/journal.pone.0217140 |
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