Trauma injury, severity, and outcomes among pediatric American Indian/Alaska Natives in the North Central United States

Abstract

BackgroundThere is a disproportionately higher trauma morbidity between American Indian/Alaska Native (AI/AN) and non-AI/AN children. ObjectiveTo characterize and compare trauma in AI/AN and non-AI/AN children presenting to a Regional Pediatric Level II Trauma Center (Adult Level I Trauma Center). MethodA retrospective observational study of all children <20 years presenting from 2012–2018. Descriptive data were analyzed along with T-tests to determine if demographic and clinical characteristics were different for AI/AN and non-AI/AN children. ResultsAI/AN children are more likely to be referred from outside hospitals [OR 5.61, 95% CI 3.79, 8.29], to have penetrating injuries [OR 3.87, 95% CI 1.88, 7.99] and have higher likelihood of both minor [OR 1.48, 95% Cl 1.06, 2.07] and major [OR 1.99, 95% Cl 1.37, 2.87] trauma activation on arrival. More AI/AN children suffer violent injuries [OR 3.12, 95% CI 1.90, 5.01], utilized Intensive Care Unit (ICU) [OR 1.54 95% CI 1.10, 2.14], had prolonged length of stay (LOS) [OR 1.52, 95% Cl 1.28, 1.80], and were less likely discharged home [OR 0.65, 95% Cl 0.44, 0.96]. ConclusionsAI/AN pediatric trauma patients suffer higher morbidity compared to non-AI/AN pediatric trauma patients. This study provides data which supports the need for future interventions to decrease the burden of injury noted among AI/AN children. Study TypeTreatment Study Type and Level of EvidenceRetrospective comparative study; Level III