Table 2. Summary of Meta-Analyses Results for Children Admitted to Hospitals Following Trauma Treated at a Pediatric Trauma Center vs an Adult Trauma Center or a Combined Adult and Pediatric Center.
| Outcome | Pooled effect estimates OR (95% CI; 95% PI) |
No. (I2, %) | Risk of biasa |
|---|---|---|---|
| Mortality | |||
| PTC vs ATC, all | 0.59 (0.46-0.76; 0.22-1.59) | 23 (78) | Serious |
| Aged ≤16 y | 0.50 (0.31-0.81; 0.15-1.71) | 9 (64) | Serious |
| Aged ≥14 y | 0.71 (0.47-1.06; 0.21-2.38) | 11 (76) | Serious |
| Head injuries | 0.66 (0.51-0.84; 0.08-5.13) | 3 (<1) | Serious |
| Blunt solid organ injuries | 0.67 (0.03-12.79; NA) | 3 (91) | Serious |
| Penetrating injuries | 0.48 (0.35-0.67; 0.30-0.77) | 4 (<1) | Serious |
| ISS ≥12 | 0.60 (0.16-2.25; NA) | 3 (77) | Serious |
| Level I | 0.48 (0.30-0.76; 0.13-1.72) | 8 (87) | Serious |
| Level I and II | 0.56 (0.41-0.76; 0.34-0.93) | 10 (44) | Serious |
| Level I and II with same verification organization | 0.38 (0.20-0.75; 0.09-1.57) | 4 (34) | Serious |
| US | 0.68 (0.53-0.86; 0.29-1.57) | 19 (77) | Serious |
| Other countries | 0.27 (0.15-0.48; 0.11-0.69) | 4 (<1) | Serious |
| 2010 to 2014b | 0.65 (0.45-0.94; 0.26-1.62) | 10 (74) | Serious |
| 2015 to 2019b | 0.60 (0.37-0.99; 0.14-2.58) | 10 (81) | Serious |
| Moderate or serious risk of biasc | 0.53 (0.41-0.69; 0.23-1.25) | 18 (76) | Serious |
| Critical risk of bias | 0.80 (0.36-1.76; 0.10-6.42) | 5 (84) | Serious |
| Transfers excluded | 0.58 (0.47-0.71; 0.34-0.99) | 14 (49) | Serious |
| Transfers included, adjustment | 0.70 (0.40-1.22; 0.30-1.60) | 4 (41) | Serious |
| Transfers included, no adjustment | 0.42 (0.12-1.45; 0.01-12.62) | 5 (91) | Serious |
| PTC vs CTC | 0.73 (0.53-0.99; 0.36-1.46) | 1 (69) | Serious |
| Complications | |||
| PTC vs ATC, all | 0.80 (0.41-1.56; 0.03-24.19) | 3 (69) | Critical |
| Level I and II | 0.80 (0.41-1.56; 0.03-24.19) | 3 (69) | Serious |
| Computed tomography imaging | |||
| PTC vs ATC, all | 0.48 (0.26-0.89; 0.08-2.75) | 7 (96) | Serious |
| Operative management of blunt solid organ injury | |||
| PTC vs ATC, all | 0.36 (0.23-0.57; 0.10-1.29) | 8 (76) | Serious |
| Level I | 0.24 (0.24-0.24; NA) | 2 (NA) | Serious |
| Level I and II | 0.38 (0.21-0.69; 0.09-1.71) | 6 (79) | Serious |
| Level I and II with same verification organization | 0.59 (0.03-12.30; NA) | 2 (20) | Serious |
Abbreviations: ATC, adult trauma centers; CTC, combined trauma centers; ISS, injury severity score; NA, not applicable; PI, prediction intervals; PTC, pediatric trauma centers.
a
Using the Risk of Bias in Nonrandomized Studies of Interventions tool.
b
Dates correspond to last year of patient recruitment.
c
One study with moderate and 17 with serious risk of bias.