The associations between injury mechanism and extended hospital stay among pediatric patients: findings from a trauma Center in Saudi Arabia

Journal Article
Magazine \ Newspaper: 
BMC Pediatrics
Publication Abstract: 

Abstract

Background:

A hospitalized patient’s length of stay (LOS) can have a significant impact on the performance andoperating cosAbstract

Background:A hospitalized patient’s length of stay (LOS) can have a significant impact on the performance andoperating costs of a healthcare facility. Among pediatric patients, traumatic injuries are common causes ofemergency room visits and hospitalizations. In Saudi Arabia, little is known about the burden of pediatric traumason population health and the healthcare facilities. Therefore, the aim of this study was to investigate theassociations between traumatic pediatric injury mechanisms and extended LOS in a trauma center.

Methods:
Data was obtained from the trauma registry. From 2001 to 2018, trauma patients between the ages of 0and 18 years old with LOSs of > 0 days were analyzed. The independent variable was the injury mechanism, whichwas classified as follows: falls, burns, drowning, motor vehicle collisions, motorcycle collisions, pedestrian, andintentional injuries. The dependent variable was an extended LOS defined as≥21 days. A multivariate logisticregression analysis was used to evaluate the associations between the injury mechanisms and an extended LOS.

Results:
A total of 5563 pediatric patients were included in this study. Of those, 774 (14%) had extended LOSs.Those patients with extended LOSs suffered more severe injuries than those with short hospital stays as measuredby the Injury Severity Score (mean scores: 15.4 vs. 6.8,p< 0.01), the Glasgow Coma Scale score (mean scores: 10.4vs, 14.0,p< 0.01), and the Revised Trauma Score (mean scores: 9.9 vs. 11.0,p< 0.01). Approximately one half of thepatients with extended LOSs were admitted due to motor vehicle injuries. In addition, those patients were almostfive times more likely to have extended LOSs than the patients who suffered fall injuries (odds ratio: 4.8, 95%confidence interval: 3.2–7.1).

Conclusions:
Based on the study results, motor vehicle injuries were significantly associated with extendedhospitalizations. Prevention is instrumental for reducing healthcare utilization; therefore, these findings call forpublic health professionals and policymakers to plan, design, and implement preventive measures to reduce thetraffic injury burden. In addition, increased traffic law enforcement, such as the use of car restraints, is warranted toreduce the preventable injuries and improve the overall population health.K
eywords:Injury mechanism, Length of stay, Pediatric trauma, Saudi Arabiats of a healthcare facility. Among pediatric patients, traumatic injuries are common causes ofemergency room visits and hospitalizations. In Saudi Arabia, little is known about the burden of pediatric traumason population health and the healthcare facilities. Therefore, the aim of this study was to investigate theassociations between traumatic pediatric injury mechanisms and extended LOS in a trauma center.Methods:Data was obtained from the trauma registry. From 2001 to 2018, trauma patients between the ages of 0and 18 years old with LOSs of > 0 days were analyzed. The independent variable was the injury mechanism, whichwas classified as follows: falls, burns, drowning, motor vehicle collisions, motorcycle collisions, pedestrian, andintentional injuries. The dependent variable was an extended LOS defined as≥21 days. A multivariate logisticregression analysis was used to evaluate the associations between the injury mechanisms and an extended LOS.Results:A total of 5563 pediatric patients were included in this study. Of those, 774 (14%) had extended LOSs.Those patients with extended LOSs suffered more severe injuries than those with short hospital stays as measuredby the Injury Severity Score (mean scores: 15.4 vs. 6.8,p< 0.01), the Glasgow Coma Scale score (mean scores: 10.4vs, 14.0,p< 0.01), and the Revised Trauma Score (mean scores: 9.9 vs. 11.0,p< 0.01). Approximately one half of thepatients with extended LOSs were admitted due to motor vehicle injuries. In addition, those patients were almostfive times more likely to have extended LOSs than the patients who suffered fall injuries (odds ratio: 4.8, 95%confidence interval: 3.2–7.1).Conclusions:Based on the study results, motor vehicle injuries were significantly associated with extendedhospitalizations. Prevention is instrumental for reducing healthcare utilization; therefore, these findings call forpublic health professionals and policymakers to plan, design, and implement preventive measures to reduce thetraffic injury burden. In addition, increased traffic law enforcement, such as the use of car restraints, is warranted toreduce the preventable injuries and improve the overall population health.

Keywords:
Injury mechanism, Length of stay, Pediatric trauma, Saudi Arabia