Table 3.
Predictors of a) hospital admission and b) ED death for children with moderate and severe injury seen in California emergency departments, 2005-2009
| Characteristics |
Hospital Admission Adjusted Odds Ratio* (95% CI) |
ED Death Adjusted Odds Ratio* (95% CI) |
||
|---|---|---|---|---|
| Injury Severity | ||||
| Moderate | REF | -- | REF | -- |
| Severe | 5.02 | (4.61, 5.47) | 12.91 | (10.39, 16.05) |
| Age | ||||
| <1 year | 1.04 | (0.96, 1.13) | 3.79 | (2.42, 5.93) |
| 1-4 years | 1.13 | (1.05, 1.22) | 4.05 | (2.83, 5.80) |
| 5-9 years | 1.22 | (1.14, 1.31) | 2.01 | (1.37, 2.95) |
| 10-14 years | 1.10 | (1.03, 1.17) | 1.62 | (1.20, 2.18) |
| 15-18 years | REF | -- | REF | -- |
| Sex | ||||
| Male | REF | -- | REF | -- |
| Female | 0.74 | (0.71, 0.78) | 0.74 | (0.58, 0.95) |
| Race/Ethnicity | ||||
| White | REF | -- | REF | -- |
| Black/African-American | 0.98 | (0.89, 1.08) | 0.85 | (0.59, 1.22) |
| Hispanic | 1.07 | (1.01, 1.13) | 0.96 | (0.74, 1.25) |
| Asian | 1.11 | (1.00, 1.24) | 0.84 | (0.46, 1.54) |
| Other | 1.08 | (0.97, 1.19) | 1.46 | (0.95, 2.25) |
| Annual Median Household Income^ | ||||
| <100% Federal Poverty Line (FPL) | REF | -- | REF | -- |
| 100-200% FPL | 0.81 | (0.53, 1.25) | 0.58 | (0.16, 2.09) |
| 200-300% FPL | 0.80 | (0.52, 1.22) | 0.51 | (0.14, 1.81) |
| >300% FPL | 0.86 | (0.56, 1.31) | 0.42 | (0.12, 1.52) |
| Distance: Residence to Nearest Acute Hospital |
||||
| 0-5 miles | REF | -- | REF | -- |
| 6-10 miles | 1.02 | (0.95, 1.11) | 1.48 | (1.04, 2.11) |
| >10 miles | 1.10 | (0.99, 1.21) | 1.38 | (0.88, 2.17) |
| Insurance Status | ||||
| Private Insurance | REF | -- | REF | -- |
| Public Insurance | 1.34 | (1.28, 1.41) | 0.91 | (0.70, 1.18) |
| No Insurance | 0.50 | (0.46, 0.55) | 3.11 | (2.38, 4.06) |
| Rural Status | ||||
| Urban | REF | -- | REF | -- |
| Rural | 0.79 | (0.73, 0.86) | 0.77 | (0.51, 1.15) |
| Mechanism of Injury | ||||
| Fall | REF | -- | REF | -- |
| Cut | 6.08 | (4.98, 7.41) | 89.61 | (44.9, 179.0) |
| Firearm | 6.63 | (5.58, 7.87) | 513.9 | (287.1, 919.9) |
| Motor Vehicle Traffic | 3.84 | (3.58, 4.12) | 58.48 | (37.55, 91.07) |
| Pedal (Bike) | 1.00 | (0.90, 1.10) | 0.71 | (0.10, 5.32) |
| Pedestrian | 3.17 | (2.14, 4.69) | 65.73 | (25.55, 169.1) |
| Struck | 0.62 | (0.58, 0.66) | 1.80 | (0.94, 3.47) |
| Drowning | 3.04 | (1.13, 8.22) | <0.01 | (<0.01, >999) |
| Machinery | 0.43 | (0.27, 0.69) | 16.48 | (3.67, 74.03) |
| Other Transportation | 2.14 | (1.94, 2.37) | 7.69 | (3.38, 17.46) |
| Other | 0.67 | (0.57, 0.79) | 2.69 | (0.63, 11.58) |
| Intent of Injury | ||||
| Unintentional | REF | -- | REF | -- |
| Intentional | 3.18 | (1.65, 6.13) | 2.63 | (0.80, 8.62) |
| Assault | 1.22 | (1.11, 1.35) | 0.79 | (0.52, 1.19) |
| Undetermined | 1.79 | (1.19, 2.68) | 4.64 | (2.16, 9.96) |
Discharged = 14,222 visits; admission = 34,402 visits; death = 467 visits; total = 49,091 visits.
REF = Reference variable
The adjusted model includes the following variables: age, sex, race/ethnicity, annual median household income, distance from residence to nearest acute hospital, insurance status, rural status, mechanism of injury, and intent of injury. The Vuong’s closeness test showed that our model was a significant improvement over a reduced base model, with a chi-square statistic = 588943, p-value < 0.005.
Income based on zip code of residence, using the 2004 Federal Poverty Line of $18,850 for a family of four.
Trend analysis for all injuries by year showed later years with decreasing likelihood of admission and death.