• Shannon E Yancovich, Alessandra Guiner, Noormah Mehmood, Ediri Nesiama, Parker Ragle, Joan S Reisch, and NesiamaJo-Ann OJODepartment of Pediatric Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code: 9063, Dallas, TX 75390, United States of America..
• Department of Pediatric Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code: 9063, Dallas, TX 75390, United States of America. Electronic address: Shannon.yancovich@utsouthwestern.edu.
• Am J Emerg Med. 2025 Feb 1; 88: 197203197-203.

BackgroundMost injured children are initially seen at non-pediatric hospitals, then transferred to a pediatric trauma center for definitive care. Published outcomes of transferred children with blunt abdominal trauma (BAT) are sparse. Our objective is to describe this population and their disposition at a pediatric trauma center.MethodsThe study was performed at a level-1 pediatric trauma center (PTC) using data collected from electronic medical records and trauma registry. Patients 0-18 years with BAT transferred from outside facilities (OSF) between 2009 and 2019. Penetrating injuries were excluded. 923 patients were analyzed and grouped by whether computed tomography abdominal/pelvis (CTa/p) was obtained at each facility. Those with positive CTa/p at OSF were also compared to those with positive CTa/p results at our PTC. Descriptive statistics evaluated demographics, injury mechanism, Glasgow Coma Scale (GCS), Injury Severity Scale (ISS), disposition, and length of stay (LOS).ResultsMales had higher predominance of positive CTa/p at both OSF and PTC (p = 0.0012), with motor vehicle crash (MVC) being the most common injury mechanism (p = 0.0002). Patients with positive CTa/p at PTC (n = 156) were associated with statistically higher ISS, lower GCS, more dispositions to OR and ICU, and longer LOS (all p < 0.005). Of patients with negative CTa/p at OSF (n = 41), none received subsequent CTa/p upon arrival to PTC and only 2 were admitted in the setting of head trauma. Of the patients without CTa/p performed at either facility or negative CTa/p at PTC (n = 23), most were admitted for non-abdominal trauma.ConclusionCompared to those with positive CTa/p at OSF, children who had positive CTa/p at PTC were younger, had higher ISS scores, and longer LOS, suggesting they were more seriously injured. Children with BAT and negative CTa/p in absence of other injuries, may not require transfer to a PTC. Enhanced understanding of these patients may reduce unnecessary transfers, improving resource utilization.Published by Elsevier Inc.

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