Phillip M. Lee,1 Nikita Nunes Espat,2 Adel Elkbuli3
1 John A. Burns School of Medicine, University of Hawaiʻi, Honolulu, HI
2 NOVA Southeastern College of Osteopathic Medicine Department of Radiology, Fort Lauderdale, FL
3 Orlando Health Regional Center Department of Trauma Surgery, Orlando, FL
This study aims to assess the impact of transfer to a higher-level trauma center on the clinical outcomes of pediatric severe traumatic brain injury patients. This retrospective cohort study utilized the ACS-TQIP-PUF database between 2017-2023 to evaluate pediatric TBI trauma patients transferred from lower-level to higher-level trauma centers. The primary outcome was odds of discharge within 24 or 48 hours without requiring neurosurgical intervention in addition to rates of neurosurgical interventions. Secondary outcomes included mortality rates, imaging rates, intensive care unit length-of-stay, ventilation-free days, and discharge home. 4,154 pediatric patients with isolated severe TBI were assessed, which 1,723 (41.5%) were transferred to a higher-level trauma center. Patients transferred to higher level PTCs had 42% reduced odds to be discharged within 24 hours without NSI (OR: 0.576, 95% CI: 0.414-0.801, p<0.001), were 1.3 times more likely to undergo neurosurgical intervention (OR: 1.264, 95% CI: 1.044-1.531, p=0.016), and 1.6 times more likely to be discharged to their home residence (OR: 1.583, 95% CI: 1.304-1.922, p<0.001). There were no significant differences in mortality. Transfer to higher-level TCs required surgical intervention and discharged home more frequently.
