The AIS coders at UMCU scored the most AIS codes of ≥ 4. The reliability between the coders and the original trauma registry scores was 0.50, 0.50, and 0.41 in, respectively, UMCU, JHH, and HMC. Reliability between coders and trauma centers was measured with the intraclass correlation coefficient (ICC). international level I trauma centers.Ī total 150 patients (50 per center) were randomly selected from each respective trauma registry: University Medical Center Utrecht (UMCU), the Netherlands John Hunter Hospital (JHH), Australia and Harborview Medical Center (HMC), the United States. This study evaluated the inter-rater and intra-rater reliability of Abbreviated Injury Scale (AIS) scores of patients with severe TBI across three. This could be partly attributed to variability in the severity coding of the injuries. Substantial difference in mortality following severe traumatic brain injury (TBI) across international trauma centers has previously been demonstrated. Future studies are needed to determine optimal criteria for transfer of renal trauma pediatric patients to level 1 trauma centers. Transferred patients receive similar radiation exposure and may not be at increased risk for immediate or long-term complications. When comparing patients who transferred =50 miles, there was a non-significant increase in immediate complications in the >=50 miles group. There were no statistically significant differences in repeat imaging, immediate complications, follow-up visits, or long-term adverse outcomes for transferred vs. Statistical analyses using Fisher’s Exact and Kruskal-Wallis tests were performed.Ģ6 transferred and 9 non-transferred patients met inclusion criteria. Data collected included clinical complications, number of follow-up visits, long-term sequelae, and imaging techniques used. pediatric trauma center following acute renal trauma after external trauma of any AAST grade and any mechanism of injury. We performed a retrospective chart review of patients 0-18 years-olds seen at our level 1. The purpose of our study is to describe the outcomes of pediatric patients who were transferred from an outside hospital versus those presenting initially to our level 1 pediatric trauma center. Patients with traumatic kidney injuries often require transfer to tertiary trauma centers. Possible improvements to rural trauma care include bolstering the quality of care in Level III trauma centers, increasing Level II center efficiency through the involvement of orthopedic traumatologists, placing medical helicopter bases in more strategic locations that enable transport teams to reach other trauma centers faster, building more Level I and Level II trauma centers, and converting Level III centers into either Level I or Level II centers. Improvements in access to high-tier traumatic care must occur in order to reduce mortality due to traumatic injuries in underserved rural areas. Therefore, these areas tend to have a greater mortality rate in relation to traumatic injuries. Furthermore, trauma centers tend to be widely dispersed with respect to rural areas. Level III to Level V trauma centers tend to be dominantly situated in rural and underserved areas. However, there is a major inequity in access to trauma centers across the United States, especially amongst rural residents. Level V trauma centers are the least comprehensive, providing minimal 24-hour care and resuscitation, and Level I trauma centers are the most comprehensive, accepting the most severely injured patients and always delivering care through the use of an attending surgeon. These trauma centers are classified into five different levels: Level I to Level V. Trauma centers in the United States focus on providing care to patients who have suffered injuries and may require critical care.

Trauma center levels of care