Abstract
Background
Motor vehicle crashes (MVCs) are a principal cause of death in children; fatal MVCs
and pediatric trauma resources vary by state. We sought to examine state-level variability
in and predictors of prompt access to care for children in MVCs.
Materials and methods
Using the 2010-2014 Fatality Analysis Reporting System, we identified passengers aged
<15 y involved in fatal MVCs (crashes on US public roads with ≥1 death, adult or pediatric,
within 30 d). We included children requiring transport for medical care from the crash
scene with documented time of hospital arrival. Our primary outcome was transport
time to first hospital, defined as >1 or ≤1 h. We used multivariable logistic regression
to establish state-level variability in the percentage of children with transport
time >1 h, adjusting for injury severity (no injury, possible injury, suspected minor
injury, suspected severe injury, fatal injury, and unknown severity), mode of transport
(emergency medical services [EMS] air, EMS ground, and non-EMS), and rural roads.
Results
We identified 18,116 children involved in fatal MVCs from 2010 to 2014; 10,407 (57%)
required transport for medical care. Median transport time was 1 h (interquartile
range: [1, 1]; range: [0, 23]). The percent of children with transport time >1 h varied
significantly by state, from 0% in several states to 69% in New Mexico. Children with
no injuries identified at the scene and crashes on rural roads were more likely to
have transport times >1 h.
Conclusions
Transport times for children after fatal MVCs varied substantially across states.
These results may inform state-level pediatric trauma response planning.
Keywords
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Article info
Publication history
Published online: May 08, 2017
Accepted:
April 27,
2017
Received in revised form:
March 24,
2017
Received:
February 11,
2017
Footnotes
This work was presented as an oral presentation at the Academic Surgical Congress in Las Vegas, February 7-9, 2017. A portion of this work was presented at the Annual Massachusetts Committee on Trauma Resident Papers Competition in Boston, October 14, 2016.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
