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Management of Children and Adolescents with Chest Trauma in Pediatric and Non-Pediatric Departments-A Claims Data Analysis

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Specialty Health Services
Date 2023 Mar 29
PMID 36980070
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Abstract

Background: To investigate the management of children and adolescents with isolated and combined chest trauma in pediatric (PD) and non-pediatric departments (non-PD).

Methods: Anonymized claims data were provided by two large German statutory health insurance funds, covering 6.3 million clients over a 10-year period (2010-2019). Data were extracted for patients who had an inpatient ICD diagnosis of section S20-S29 (injuries to the thorax) and were ≤18 years of age. Demographic and clinical data were analyzed.

Results: A total of 4064 children and adolescents with chest trauma were included (mean age 12.0 ± 5.0 years; 55% male). In 1928 cases (47.4%), treatment was provided at PD. Patients admitted to PD underwent CT imaging less frequently (8.1%; non-PD: 23.1%; < 0.0001). Children with a chest drain treated at university/maximum care hospitals (UM) showed more injuries involving multiple body regions compared with non-UM (25.8% vs. 4.5%; = 0.0061) without a difference in the length of hospital stay.

Conclusion: Children and adolescents with chest trauma are treated almost equally often in pediatric and adult departments. CT is significantly less frequently used in pediatric departments. Patients with a chest drain treated at a UM showed more concomitant injuries without a longer hospital stay. However, the clinical validity of this finding is questionable.

References
1.
Alemayehu H, Aguayo P . Pediatric Blunt Thoracic Trauma. J Pediatr Intensive Care. 2019; 4(1):35-39. PMC: 6513125. DOI: 10.1055/s-0035-1554987. View

2.
Gosemann J, Lange A, Zeidler J, Blaser J, Dingemann C, Ure B . Appendectomy in the pediatric population-a German nationwide cohort analysis. Langenbecks Arch Surg. 2016; 401(5):651-9. DOI: 10.1007/s00423-016-1430-3. View

3.
Walther A, Falcone R, Pritts T, Hanseman D, Robinson B . Pediatric and adult trauma centers differ in evaluation, treatment, and outcomes for severely injured adolescents. J Pediatr Surg. 2016; 51(8):1346-50. PMC: 5558261. DOI: 10.1016/j.jpedsurg.2016.03.016. View

4.
Stormann P, Weber J, Jakob H, Marzi I, Schneidmueller D . [Thoracic injuries in severely injured children : Association with increased injury severity and a higher number of complications]. Unfallchirurg. 2017; 121(3):223-229. DOI: 10.1007/s00113-017-0312-7. View

5.
Sathya C, Alali A, Wales P, Scales D, Karanicolas P, Burd R . Mortality Among Injured Children Treated at Different Trauma Center Types. JAMA Surg. 2015; 150(9):874-81. DOI: 10.1001/jamasurg.2015.1121. View