Hospital Teaching Status Influence on Pediatric Gunshot Wounds to the Head Outcomes: A National Trauma Data Bank Study

Sunday, May 5, 2024

3:41 PM – 3:43 PM CT

Location: S405b

Presenting Author(s)

Courtney Deaver, BS

Medical Student
University of Arizona College of Medicine, Neurosurgery Department, Phoenix AZ
Gilbert, AZ, US
Annie Pico, BA

Medical Student
University of Arizona College of Medicine, Neurosurgery Department, Phoenix AZ
Chandler, AZ, US

Co-Author(s)

RB

Robert W. Bina, MD

Assistant Professor of Neurosurgery
University of Arizona College of Medicine, Neurosurgery Department, Phoenix AZ
Phoenix, Arizona, United States
SF

Sofia Fabrega, B.S.

Medical Student
The University of Arizona College of Medicine - Phoenix, United States
PN

Peter Nakaji, MD

Chair, Department of Neurosurgery
University of Arizona College of Medicine, Neurosurgery Department, Phoenix AZ
Phoenix, Arizona, United States
DP

Daniel Pietz, MS

Data Analyst
University of Arizona College of Medicine - Phoenix, Department of Neurosurgery, United States
KZ

Kevin Zhao, MD

Clinical Fellow
University of Arizona College of Medicine – Phoenix, Banner University Medical Center
Phoenix, Arizona, United States

Disclosure(s):

Courtney Deaver, BS: No financial relationships to disclose

Annie Pico, BA: No financial relationships to disclose

Introduction: Differences in outcomes following gunshot wounds to the head have been found among community, non-teaching, and university hospitals; however, this has yet to be studied in pediatric gunshot wounds to the head (GSWH).

Methods: The National Trauma Data Bank was queried for patients ages 18 and younger who suffered GSWH from 2010 to 2021. Teaching status of hospitals were categorized into teaching and non-university hospitals. Patient demographics and outcomes in relation to teaching status were analyzed.

Results: Between 2010 and 2021, 52,125 patients with GSWH were identified.10,064 patients were treated at a university hospital and 5876 patients were treated at community and non-university hospitals. Mortality rate at teaching hospitals was 4.8% compared to the mortality rate at non-teaching hospitals, which was 5.3% (p < 0.001). No significant differences were identified between teaching and non-university hospitals in superficial (0.27% teaching vs 0.20% non-university) or deep (0.30% vs 0.20%) surgical site infection, organ space infection (0.49% vs 0.41%), sepsis (0.15% vs 0.09%), unplanned ICU stay (0.26% vs 0.22%), unplanned intubation (0.16% vs 0.22%), and unplanned return to the OR (0.62% vs 0.48%).

Conclusion : Teaching and non-teaching hospitals have similar outcomes in pediatric GSWH; however, the overall mortality rate is lower in teaching hospitals. Further research into this difference may be beneficial for improving disparities in care provided for pediatric GSWH patients.