Outcomes and predictors of unplanned intensive care unit admission for pediatric trauma patients.

IF 1.4 Q3 SURGERY Surgery open science Pub Date : 2024-12-18 eCollection Date: 2025-01-01 DOI:10.1016/j.sopen.2024.12.002

Tyler Liang, Areg Grigorian, Robert Painter, James Jeng, Theresa Chin, Laura F Goodman, Yigit S Guner, Catherine Kuza, Jeffry Nahmias

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Abstract

Background: Unplanned intensive care unit (ICU) admission (UIA) is associated with increased morbidity in adult trauma patients, however, is not well studied in pediatric trauma patients (PTPs). We sought to identify predictors of UIA, hypothesizing PTPs with UIA have increased odds of mortality.

Methods: The 2017-2019 Trauma Quality Improvement Program (TQIP) database was queried for PTPs ≤16-years-old admitted to non-ICU level of care. Patients with UIA were compared to those without UIA. Multivariable logistic regression analysis was performed to determine predictors of UIA.

Results: From 142,160 PTPs, 233 patients had UIA (<1 %). The UIA group had increased acute kidney injury (2.6 % vs 0 %, p < 0.001), length of stay (7 vs 2 days, p < 0.001), and mortality (1.3 % vs. 0.1 %, p < 0.001). Independent predictors of UIA included ureteral, esophageal, and brain injury (all p < 0.001).

Conclusion: UIA for PTPs is rare but associated with increased complications and death. Significant predictors of UIA include ureteral, esophageal and brain injury.

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儿科创伤患者非计划入住重症监护病房的结局和预测因素。

背景：非计划重症监护病房（ICU）入住（UIA）与成人创伤患者的发病率增加有关，然而，在儿科创伤患者（PTPs）中尚未得到很好的研究。我们试图确定UIA的预测因素，假设ptp与UIA的死亡率增加。方法：查询2017-2019年创伤质量改善计划（TQIP）数据库，收集≤16岁入住非icu护理级别的ptp患者。将有UIA的患者与没有UIA的患者进行比较。采用多变量logistic回归分析确定UIA的预测因素。结果：在142160名ptp患者中，233名患者有UIA(结论：ptp患者的UIA很少见，但与并发症和死亡增加有关。UIA的重要预测因素包括输尿管、食管和脑损伤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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