Evidence map›Paper›PMID 27231667›Full record

ArticleInjury epidemiology2016

Anticipated resource utilization for injury versus non-injury pediatric visits to emergency departments.

Mark R Zonfrillo, Michelle L Macy, Lawrence J Cook, Tomohiko Funai, Rachel M Stanley, James M Chamberlain, Rebecca M Cunningham, Elizabeth R Alpern, Pediatric Emergency Care Applied Research Network (PECARN)

Abstract read
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In one paragraph

Article in Injury epidemiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mark R ZonfrilloDepartment of Emergency Medicine, Alpert Medical School of Brown University, 55 Claverick Street, 2nd Floor, Providence, RI 02903 USA
Michelle L MacyDepartment of Emergency Medicine, University of Michigan, Ann Arbor, MI USA
Lawrence J CookDepartment of Pediatrics, University of Utah, Salt Lake City, UT USA.
Tomohiko FunaiDepartment of Pediatrics, University of Utah, Salt Lake City, UT USA.
Rachel M StanleyDivision of Emergency Medicine, Nationwide Children's Hospital, Columbus, OH USA.
James M ChamberlainDepartment of Pediatrics & Emergency Medicine, Children's National Health System, George Washington University, Washington, DC, USA.
Rebecca M CunninghamDepartment of Emergency Medicine, University of Michigan, Ann Arbor, MI USA
Elizabeth R AlpernAnn and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL USA.
Pediatric Emergency Care Applied Research Network (PECARN)

Funding

The Unviersity of Michigan Injury CenterR49CE002099 · CE · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CUNNINGHAM, REBECCA M. · 2012 to 2018
$5.6M
A Brief Intervention to Increase Size-Appropriate Child Passenger Restraint UseK23HD070913 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MACY, MICHELLE LEA · 2012 to 2016
$670k
Functional Disability as a Measurement of Injury Burden in ChildrenK08HD073241 · NICHD · RHODE ISLAND HOSPITAL · PI ZONFRILLO, MARK ROBERT · 2012 to 2016
$628k
ACL HHS R49CE002099NICHD NIH HHS K08 HD073241NICHD NIH HHS K23 HD070913
6 · The paper itself

Abstract

backgroundChildhood injuries are increasingly treated in emergency departments (EDs) but the relationship between injury severity and ED resource utilization has not been evaluated. The objective of this study was to compare resource utilization for pediatric injury-related ED visits across injury-severity levels and with non-injury visits, using standardized, validated scales.

methodsA retrospective analysis of 2004-2008 ED visits from the Pediatric Emergency Care Applied Research Network Core Data Project. Maximum Abbreviated Injury Scale severity (MAIS) and Severity Classification System (SCS) scores were calculated and compared. MAIS and SCS are ordinal scales from 1 (minor injury) to 6, and 1 (low anticipated resource utilization) to 5, respectively. ED length of stay (LOS) and admission percentages were calculated as comparative proxy measures of resource utilization.

resultsThere were 763,733 injury visits and 2,328,916 non-injury visits, most with SCS of 2 or 3. Of the injured patients, 59.2 % had an MAIS of 1. ED LOS and admission percentage increased with increasing MAIS from 1-5. LOS and admission percentage increased with increasing SCS in both samples. Median LOS was shorter for injured versus non-injured patients with SCS 3-5. Non-injured patients with SCS 2-5 were more likely admitted than injured patients. Most injured patients had an SCS 3 with an MAIS 1-2, or an SCS 2 with an MAIS 1, with no correlation between the two scales.

conclusionWhile admission rates and LOS increase with increasing AIS and SCS severity, these two classification schemas do not reliably correlate. Similarly, ED visit metrics differ between injured and non-injured patients in similar SCS categories. Although AIS and SCS both have value, these differences should be considered when using these schemas in research and quality improvement.

Indexed as

AdolescentChildCoding systemsEmergency departmentInjury severityResource utilization

Identifiers

PMID27231667
PMCPMC4853460

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.