Distribution, typology and specificity of pediatric polytrauma centers in Italy.

INTRODUCTION

Polytrauma is defined by the presence of multiple traumatic injuries and poses a significant global health concern due to its associated morbidity. Clear guidelines or recommendations for the medical or surgical management of pediatric polytrauma patients are currently lacking.

AIMS: National Survey of the Management of Paediatric Polytrauma was conducted to clarify and delineate the current national standards in the care paediatric polytrauma patients.

MATERIAL AND

METHODS

We conducted a survey among senior physicians from the Italian Society of Pediatric Surgery and the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care. The survey focused on the management of pediatric polytrauma and compared practices between pediatric and hybrid hospitals, as well as between high- and low-volume centers.

RESULTS

A national survey of 52 institutions revealed that 33% were paediatric hospitals and 67% were hybrid institutions treating adult patients. We found that 89% of the institutions had a dedicated paediatric emergency department, and 44% had a senior paediatric surgeon on call. Most hospitals had a dedicated paediatric intensive care unit, 72% had a multidisciplinary trauma team, and 94% had an internal protocol for paediatric polytrauma management. We found no significant differences in the number of second-level paediatric emergency departments, availability of paediatric surgeons, multidisciplinary trauma teams, or imaging modalities. High-volume centres had a higher annual incidence of polytrauma than low-volume centres.

CONCLUSION

The study provides important insights into the current state of paediatric polytrauma management in the Italian healthcare system. The study emphasised the crucial need for standardisation, specialised training, and the development of evidence-based guidelines. The proposed national trauma registry will be instrumental in facilitating this process and improving the quality of care for paediatric polytrauma patients in Italy. Further research examining the effect of volume, training, and guideline implementation on patient outcomes will significantly enhance this field.