Chronic conditions and outcomes of pediatric trauma patients

Abstract

Background: Chronic conditions influence the outcomes of adult trauma patients, but no study has investigated the impact of chronic conditions among pediatric trauma patients.

Methods: We performed a retrospective study using the 2009 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) to determine the prevalence of chronic conditions among pediatric trauma patients (ages 1-15 years) and to assess the impact of chronic conditions on care resource use and patient mortality.

Results: According to the 2009 KID, an estimated 22,965 or 24.6% of US pediatric trauma patients had preexisting chronic conditions. The most common chronic conditions were mental disorders (7.8%), diseases of the respiratory system (7.7%), and diseases of the nervous system and sensory organs (6.3%). Compared with pediatric trauma patients without chronic conditions, patients with chronic conditions had a longer average stay in the hospital of 5.2 days (95% confidence interval [CI], 4.8-5.5) versus 2.5 days (95% CI, 2.4-2.6). They also had higher hospital charges of $50,815 (95% CI, $47,126-$54,503) versus $23,655 (95% CI, $22,242-$25,067) and a higher mortality rate of 2.6% (95% CI, 2.3-2.9%) versus 0.1% (95% CI, 0.1-0.1%).

Conclusion: Nearly one fourth of pediatric trauma patients had preexisting chronic conditions, and their mortality risk was significantly higher. Treatment guidelines and more research in this special group of trauma patients are warranted.