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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Pediatr+Surg 2017 ; 52 (3): 382-5 Nephropedia Template TP
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Missed Injuries and Unplanned Readmissions in Pediatric Trauma Patients #MMPMID27839721
Choi PM; Yu J; Keller MS
J Pediatr Surg 2017[Mar]; 52 (3): 382-5 PMID27839721show ga
Background: We sought to determine the incidence and characteristics of missed injuries and unplanned readmissions at a Level-1 pediatric trauma center. Methods: We conducted a retrospective review of all trauma patients who presented to our ACS-Verified Level-1 pediatric trauma center from 2009?2014. Results: Overall, there were 27 readmissions and 27 missed injuries (0.38%). Patients who were unplanned readmissions had a greater Injury Severity Score (ISS) (8.6 vs 5.2, p=0.03), had longer hospitalizations (4.9 vs 2.5 days, p=0.02), and were more likely to have required operative intervention (51.9% vs 32.3%, p=0.04). Similarly, patients identified with missed injuries had a higher ISS (15.2 vs 5.2, p<0.0001), greater length of stay (12.7 vs 2.5 days, p<0.0001), and were also more likely to be intubated (25.9% vs 3.6%, p <0.0001) or require critical care (48.1% vs 10.3%, p<0.0001). Seven missed injuries were in patients who were deemed non-accidental trauma (25.9%) and significantly altered their hospital course while 10 patients (37%) required operative intervention. On multivariate analysis, only ISS was found to be an independent risk factor for readmissions and missed injuries. Conclusions: Missed injuries and unplanned readmissions were rare occurrences among our pediatric patient population. These events, however, did result in longer hospitalizations and additional procedures. Patients with multisystem injuries and compromised physical exam are at higher risk.