Tyler Liang MD , Areg Grigorian MD , Robert Painter MD , James Jeng MD , Theresa Chin MD , Laura F. Goodman MD MPH , Yigit S. Guner MD , Catherine Kuza MD , Jeffry Nahmias MD MHPE
{"title":"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。","authors":"Tyler Liang MD , Areg Grigorian MD , Robert Painter MD , James Jeng MD , Theresa Chin MD , Laura F. Goodman MD MPH , Yigit S. Guner MD , Catherine Kuza MD , Jeffry Nahmias MD MHPE","doi":"10.1016/j.sopen.2024.12.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>UIA for PTPs is rare but associated with increased complications and death. Significant predictors of UIA include ureteral, esophageal and brain injury.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"23 ","pages":"Pages 30-34"},"PeriodicalIF":1.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745942/pdf/","citationCount":"0","resultStr":"{\"title\":\"Outcomes and predictors of unplanned intensive care unit admission for pediatric trauma patients\",\"authors\":\"Tyler Liang MD , Areg Grigorian MD , Robert Painter MD , James Jeng MD , Theresa Chin MD , Laura F. Goodman MD MPH , Yigit S. Guner MD , Catherine Kuza MD , Jeffry Nahmias MD MHPE\",\"doi\":\"10.1016/j.sopen.2024.12.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>UIA for PTPs is rare but associated with increased complications and death. Significant predictors of UIA include ureteral, esophageal and brain injury.</div></div>\",\"PeriodicalId\":74892,\"journal\":{\"name\":\"Surgery open science\",\"volume\":\"23 \",\"pages\":\"Pages 30-34\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745942/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgery open science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2589845024001386\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery open science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2589845024001386","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Outcomes and predictors of unplanned intensive care unit admission for pediatric trauma patients
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.