Paediatric Care in a Combined Trauma Centre - A Retrospective Cohort Study Examining Major Trauma Processes and Outcomes.

Aim: Priorities in the assessment and management of major trauma between paediatric and adult patients vary due to clinically relevant differences in anatomy and physiology. Christchurch Hospital is a combined trauma centre, where-in a paediatric trauma service is nested into a predominantly adult hospital, providing specialist paediatric surgical care to the South Island of New Zealand. A system analysis comparing outcomes between adult and paediatric patients was undertaken to assess this service.

Methods: A retrospective analysis comparing outcomes between all paediatric and adult major trauma patients (Injury Severity score > 12) who presented to Christchurch Hospital Emergency Department (ED) between June 2016 and November 2021.

Results: A total of 1594 adult (median age 51, IQR 33-67) and 77 paediatric (median age 11, IQR 7-14) patients were identified. Median time to CT was significantly shorter in paediatric patients compared to adults (83 min vs. 96 min, p = 0.05). Similarly, the ED length of stay was significantly shorter in paediatric patients (124 min vs. 282 min, p < 0.001). The paediatric and adult mortality rates were 4% and 8% respectively (p value 0.06).

Conclusions: These results serve to establish baseline characteristics of our trauma service and demonstrate efficient paediatric trauma care delivery within our current nested paediatric trauma service model. Further research may help delineate clinical demand for population-specific trauma services and characterise trauma-specific interventions in the paediatric population.