Journal article
An investigation of social determinants of health and outcomes in pediatric nonaccidental trauma
Pediatric surgery international, v 35(8), pp 869-877
01 Aug 2019
PMID: 31147762
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
ObjectivesNonaccidental trauma (NAT) is a leading cause of pediatric mortality and disability. We examined our institution's experience with NAT to determine if socioeconomic status is correlated with patient outcomes.MethodsNAT cases were reviewed retrospectively. Socioeconomic determinants included insurance status and race; outcomes included mortality, discharge disability and disposition. Correlations were identified using t test, Fisher's exact test, and logistic regression.ResultsThe cohort comprised of 337 patients, with an overall uninsured rate of 5.6%. This rate was achieved by insuring 64.7% of the cohort after admission. Non-survivors were more likely to have no insurance coverage (14.8% versus 4.8%, p=0.041). Regression revealed that uninsured had 8 times (95% CI 1.7-38.7, p=0.008) higher in-hospital mortality than those with insurance when controlling for injury severity. Additionally, injury severity score >= 15, transfer from outside hospital, need for ICU or operative treatment were predictive of mortality. Adjusted risk factors for severe disability at discharge did not include insurance status or race, while ISS >= 15 and ICU stay were predictive.ConclusionsThere are significant associations of insurance status with pediatric NAT outcomes, highlighting that determinants other than disease severity may influence mortality and morbidity. High-risk patients should be identified to develop strategies to improve outcomes.
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Details
- Title
- An investigation of social determinants of health and outcomes in pediatric nonaccidental trauma
- Creators
- Ruth Ellen Jones - The University of Texas Southwestern Medical CenterJacqueline Babb - The University of Texas Southwestern Medical CenterKristin M. Gee - The University of Texas Southwestern Medical CenterAlana L. Beres - The University of Texas Southwestern Medical Center
- Publication Details
- Pediatric surgery international, v 35(8), pp 869-877
- Publisher
- Springer Nature
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000474423700006
- Scopus ID
- 2-s2.0-85066787248
- Other Identifier
- 991021969476704721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Pediatrics
- Surgery