Injury · 2026
Predictors of prolonged emergency department length of stay in severely injured pediatric patients.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cevik Arif Alper, Alao David O, Farooq Munawar, Abu-Zidan Fikri
Аннотация
BACKGROUND: Prolonged emergency department length of stay (ED-LOS) in severely injured pediatric patients has been associated with adverse clinical outcomes. The determinants of the prolonged length of stay in severely injured pediatric patients remain incompletely understood.
OBJECTIVES: This study aims to identify patient-, injury-, and system-level predictors of prolonged ED-LOS among severely injured pediatric trauma patients. Data for this analysis were obtained from a multicenter trauma registry.
METHODS: We retrospectively analyzed prospectively collected data from the Abu Dhabi Trauma Registry over a 10-year period (2014-2023). Patients included were under 18 years old with an Injury Severity Score (ISS) over 12. We defined prolonged ED-LOS as more than 4 h. We analyzed demographic, clinical, institutional, and temporal variables. Multivariable logistic regression identified independent predictors of prolonged ED-LOS.
RESULTS: We included 874 pediatric patients, with a median ED-LOS of 227.5 min. Prolonged ED-LOS was independently associated with treatment in teaching hospitals (OR 2.25, 95% CI 1.43-3.55), absence of trauma team activation (OR 2.08, 95% CI 1.35-3.22), and non-local nationality (OR 1.66, 95% CI 1.12-2.45). Prolonged ED-LOS was also linked to specific injury mechanisms: road traffic collisions (OR 13.89, 95% CI 1.75-110.00) and low-height falls (OR 13.87, 95% CI 1.68-114.73). Higher injury severity was associated with a decreased likelihood of prolonged ED-LOS (OR 0.94, 95% CI 0.92-0.96). The model showed acceptable discrimination (AUC 0.733).
CONCLUSIONS: Prolonged ED-LOS in severely injured pediatric patients was primarily associated with system-level factors, specifically trauma team activation and hospital characteristics. Additionally, injury mechanisms and demographic factors contributed to prolonged ED-LOS. Optimizing trauma activation protocols and workflow processes, particularly in teaching hospitals, may reduce ED-LOS and improve the efficiency of pediatric trauma care.
OBJECTIVES: This study aims to identify patient-, injury-, and system-level predictors of prolonged ED-LOS among severely injured pediatric trauma patients. Data for this analysis were obtained from a multicenter trauma registry.
METHODS: We retrospectively analyzed prospectively collected data from the Abu Dhabi Trauma Registry over a 10-year period (2014-2023). Patients included were under 18 years old with an Injury Severity Score (ISS) over 12. We defined prolonged ED-LOS as more than 4 h. We analyzed demographic, clinical, institutional, and temporal variables. Multivariable logistic regression identified independent predictors of prolonged ED-LOS.
RESULTS: We included 874 pediatric patients, with a median ED-LOS of 227.5 min. Prolonged ED-LOS was independently associated with treatment in teaching hospitals (OR 2.25, 95% CI 1.43-3.55), absence of trauma team activation (OR 2.08, 95% CI 1.35-3.22), and non-local nationality (OR 1.66, 95% CI 1.12-2.45). Prolonged ED-LOS was also linked to specific injury mechanisms: road traffic collisions (OR 13.89, 95% CI 1.75-110.00) and low-height falls (OR 13.87, 95% CI 1.68-114.73). Higher injury severity was associated with a decreased likelihood of prolonged ED-LOS (OR 0.94, 95% CI 0.92-0.96). The model showed acceptable discrimination (AUC 0.733).
CONCLUSIONS: Prolonged ED-LOS in severely injured pediatric patients was primarily associated with system-level factors, specifically trauma team activation and hospital characteristics. Additionally, injury mechanisms and demographic factors contributed to prolonged ED-LOS. Optimizing trauma activation protocols and workflow processes, particularly in teaching hospitals, may reduce ED-LOS and improve the efficiency of pediatric trauma care.