Liang Tyler, Grigorian Areg, Painter Robert, Jeng James, Chin Theresa, Goodman Laura F, Guner Yigit S, Kuza Catherine, Nahmias Jeffry
Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California Irvine, 101 The City Dr S, Orange, CA 92868, USA.
Children's Health of Orange County, 1201 W La Veta Ave, Orange, CA 92868, USA.
Surg Open Sci. 2024 Dec 18;23:30-34. doi: 10.1016/j.sopen.2024.12.002. eCollection 2025 Jan.
Unplanned intensive care unit (ICU) admission (UIA) is associated with increased morbidity in adult trauma patients, however, is not well studied in pediatric trauma patients (PTPs). We sought to identify predictors of UIA, hypothesizing PTPs with UIA have increased odds of mortality.
The 2017-2019 Trauma Quality Improvement Program (TQIP) database was queried for PTPs ≤16-years-old admitted to non-ICU level of care. Patients with UIA were compared to those without UIA. Multivariable logistic regression analysis was performed to determine predictors of UIA.
From 142,160 PTPs, 233 patients had UIA (<1 %). The UIA group had increased acute kidney injury (2.6 % vs 0 %, p < 0.001), length of stay (7 vs 2 days, p < 0.001), and mortality (1.3 % vs. 0.1 %, p < 0.001). Independent predictors of UIA included ureteral, esophageal, and brain injury (all p < 0.001).
UIA for PTPs is rare but associated with increased complications and death. Significant predictors of UIA include ureteral, esophageal and brain injury.
非计划入住重症监护病房（ICU）（UIA）与成年创伤患者发病率增加相关，但在儿童创伤患者（PTPs）中尚未得到充分研究。我们试图确定UIA的预测因素，假设发生UIA的PTPs死亡几率增加。
查询2017 - 2019年创伤质量改进计划（TQIP）数据库，纳入入住非ICU护理级别的16岁及以下PTPs。将发生UIA的患者与未发生UIA的患者进行比较。进行多变量逻辑回归分析以确定UIA的预测因素。
在142,160例PTPs中，233例发生UIA（<1%）。UIA组急性肾损伤发生率更高（2.6%对0%，p < 0.001）、住院时间更长（7天对2天，p < 0.001）以及死亡率更高（1.3%对0.1%，p < 0.001）。UIA的独立预测因素包括输尿管、食管和脑损伤（均p < 0.001）。
PTPs发生UIA的情况罕见，但与并发症和死亡增加相关。UIA的重要预测因素包括输尿管、食管和脑损伤。
