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A Pediatric Application of the STRAC Regional Hospital Trauma Registry Database: Pediatric Trauma Deaths in South Central Texas During 2004-2013

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Journal Article - Open Access

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San Antonio Military Medical Center Fort Sam Houston United States

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The purpose of this study was to define the demographics of pediatric traumatic injuries and to understand the predictive value of injury type, prehospital, and emergency department ED data regarding the mortality of pediatric trauma patients 14 years of age in South Central Texas. We report a retrospective review of pediatric trauma patients presenting to Trauma Service Area P in South Central Texas during 2004-2013. The primary outcome was mortality secondary outcomes were ventilator days, hospital days, and intensive care unit stay. Demographics, Abbreviated Injury Score AIS codes, ICD-9 codes, transport times, Emergency Medical Services EMS vital signs en route and on arrival to the emergency department ED, and outcomes were evaluated. A total of 8004 traumatically injured children presented to EDs in South Central Texas during the study period 4109 of these presented via EMS. Most patients were Hispanic and male. Distribution was even across age groups. Overall mortality was 2 percent, and the mortality of those arriving by EMS was 3.7 percent. Abnormal vital signs and Glasgow Coma Score upon presentation to both EMS and the ED were strongly associated with mortality. Increased Injury Severity Score, the need for transfusion in the ED, and increased maximal AIS were also strongly associated with mortality. African American race was associated with increased mortality, although transport time and age were not. Most injuries overall were caused by motor vehicle collisions however, burns and falls were most common in infants. The most lethal injuries were caused by firearms mostly seen in preteens and assaults mostly seen in infants. This analysis of injured children in Southwest Texas offers insight into areas of needed quality improvement in the trauma system and potential areas to focus prevention efforts.

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  • Medicine and Medical Research
  • Medical Facilities, Equipment and Supplies

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