+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Risk Factors for Admission and Prolonged Length of Stay in Pediatric Isolated Skull Fractures

Risk Factors for Admission and Prolonged Length of Stay in Pediatric Isolated Skull Fractures

Pediatric Emergency Care 33(12): E146

This study aimed to assess management of pediatric isolated skull fracture (ISF) patients by determining frequency of admission and describing characteristics associated with patients admitted for observation compared with patients discharged directly from the emergency department (ED) and those requiring a prolonged hospitalization. We evaluated children younger than 5 years who presented with ISF using the South Carolina Traumatic Brain Injury Surveillance and Registry System data from 2001 to 2011. Outcomes analyzed included discharged from ED, admitted for less than 24 hours, and admitted for more than 24 hours (prolonged hospitalization). Bivariate analyses and a polytomous logistic regression model identified factors associated with patient disposition. Five hundred twenty-seven patients met the study criteria (ED discharge = 283 [53%]; inpatient <24 hours = 156 [29%]; inpatient >24 hours = 88 [18%]). The mean length of stay for admissions was 1.9 (SD, 1.5) days. In the regression model, ED discharges had greater odds of presenting to levels 2 to 3 hospitals (level 2: odds ratio [OR], 6.16; 95% confidence interval [CI], 3.66-10.39; level 3: OR, 30.98; 95% CI, 10.92-87.91) and lower odds of a high poverty status (OR, 0.20; 95% CI, 0.10-0.40). Prolonged hospitalizations had greater odds of concomitant injuries (OR, 2.21; 95% CI, 1.12-4.36). Admission after ISF is high despite a low risk of deterioration. High-poverty patients presenting to high-acuity medical centers are more commonly admitted for observation. Only presence of concomitant injuries was clinically predictive of prolonged hospitalization. The ability to better stratify risk after pediatric ISF would help providers make more informed decisions regarding ED disposition.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 065485832

Download citation: RISBibTeXText

PMID: 29194222

Related references

Risk Factors for Prolonged Length of Stay or Complications During Pediatric Respiratory Hospitalizations. Hospital Pediatrics 5(9): 461-473, 2015

Prolonged length of stay in the emergency department and increased risk of hospital mortality in patients with sepsis requiring ICU admission. Emergency Medicine Journal 36(2): 82-87, 2019

Length of stay, conditional length of stay, and prolonged stay in pediatric asthma. Health Services Research 38(3): 867-886, 2003

Concurrent prediction of hospital mortality and length of stay from risk factors on admission. Health Services Research 37(3): 631-645, 2002

Risk Factors for Prolonged Length of Stay in Abdominoplasty. Plastic and Reconstructive Surgery 136: 164-165, 2015

Perioperative factors associated with prolonged intensive care unit and hospital length of stay after pediatric neurosurgery. Pediatric Neurosurgery 47(6): 423-429, 2011

Factors affecting length of stay after isolated femoral shaft fractures. Journal of Trauma 62(3): 697-700, 2007

Risk-adjusted prolonged length of stay as an alternative outcome measure for pediatric congenital cardiac surgery. Annals of Thoracic Surgery 97(6): 2154-2159, 2014

Risk Factors for Prolonged Postpartum Length of Stay Following Cesarean Delivery. American Journal of Perinatology 32(9): 825-832, 2015

Laparoscopic cholecystectomy: do risk factors for a prolonged length of stay exist?. Updates in Surgery 71(3): 471-476, 2019

Risk factors for prolonged length of stay after major elective surgery. Annals of Surgery 230(2): 251-259, 1999

Risk factors for a prolonged length of stay in women hospitalized for preeclampsia in Texas. Hypertension in Pregnancy 29(1): 54-68, 2010

Risk Factors Associated With Perioperative Complications and Prolonged Length of Stay After Laparoscopic Adrenalectomy. JAMA Surgery 153(11): 1036-1041, 2018

Association of weekend admission with hospital length of stay, time to chemotherapy, and risk for respiratory failure in pediatric patients with newly diagnosed leukemia at freestanding US children's hospitals. JAMA Pediatrics 168(10): 925-931, 2014

Chronic conditions among children admitted to U.S. pediatric intensive care units: their prevalence and impact on risk for mortality and prolonged length of stay*. Critical Care Medicine 40(7): 2196-2203, 2012