Title: 290 Does a Dedicated Pediatric Trauma Center Reduce Door to Operating Room Times at a Level 1 Trauma Center?
Abstract: The implementation of designated pediatric trauma centers is meant to provide specialized care in a timely manner to pediatric trauma victims. Prior to August 2007, our institution received pediatric trauma victims to an adult trauma center prior to ground transfer to a geographically separate pediatric hospital. We sought to identify if moving the trauma receiving area to the pediatric emergency department (ED) at a level 1 trauma center would decrease door to operating room times. This is a retrospective cohort review of all pediatric trauma victims seen between August 2006 to July 2008 at level 1 pediatric and adult trauma centers. Two reviewers abstracted data from our institution's state-mandated trauma center database on variables including sex, age, injury severity score, hospital length of stay, and ED and operating room time-points. Pediatric trauma victims, <17 years of age, who required emergent surgical intervention were included. Patients discharged home or transferred to floor were excluded. The primary outcome measure was transit time between emergency department and operating room. Students t-test and chi square analysis were used to analyze continuous variable and population means respectively. 1728 cases were identified. 1455 cases were excluded for disposition home or admission to floor leaving a study population of 273 cases. Of these, 109 were admitted through the adult trauma center (August 2006-July2007) and 164 were admitted through the pediatric trauma center (August 2007-July 2008). Between these groups, the baseline characteristics of sex (male sex 65% v. 68%, p=0.89), age (8.7 vs. 7.8 years, p= 0.35), and injury severity score (6.6 vs. 8.0) were not statistically different. The average transit times from the ED to the operating room were 61 and 68 minutes, respectively (P=0.65). The average hospital length of stay were 3.86 and 5.18 days, respectively (p=0.35). Moving the geographical location of the pediatric trauma receiving area from the adult trauma center to the pediatric hospital did not seem to alter transit time to the operating room for those trauma patients requiring emergent surgery in this study. Further studies relating to dedicated pediatric trauma receiving areas based on specific injuries and outcomes may be useful.