Identifying Homogeneous Patterns of Injury in Paediatric Trauma Patients to Improve Risk-Adjusted Models of Mortality and Functional Outcomes

Joanna F. Dipnall, Belinda J. Gabbe, Warwick J. Teague and Ben Beck
Additional contact information
Joanna F. Dipnall: School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
Belinda J. Gabbe: School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
Warwick J. Teague: Trauma Service, The Royal Children’s Hospital, Melbourne, Victoria 3052, Australia
Ben Beck: School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia

IJERPH, 2020, vol. 17, issue 3, 1-20

Abstract: Injury is a leading cause of morbidity and mortality in the paediatric population and exhibits complex injury patterns. This study aimed to identify homogeneous groups of paediatric major trauma patients based on their profile of injury for use in mortality and functional outcomes risk-adjusted models. Data were extracted from the population-based Victorian State Trauma Registry for patients aged 0–15 years, injured 2006–2016. Four Latent Class Analysis (LCA) models with/without covariates of age/sex tested up to six possible latent classes. Five risk-adjusted models of in-hospital mortality and 6-month functional outcomes incorporated a combination of Injury Severity Score (ISS), New ISS (NISS), and LCA classes. LCA models replicated the best log-likelihood and entropy > 0.8 for all models (N = 1281). Four latent injury classes were identified: isolated head; isolated abdominal organ; multi-trauma injuries, and other injuries. The best models, in terms of goodness of fit statistics and model diagnostics, included the LCA classes and NISS. The identification of isolated head, isolated abdominal, multi-trauma and other injuries as key latent paediatric injury classes highlights areas for emphasis in planning prevention initiatives and paediatric trauma system development. Future risk-adjusted paediatric injury models that include these injury classes with the NISS when evaluating mortality and functional outcomes is recommended.

Keywords: latent class analysis; risk adjustment; paediatric; trauma; injury; mortality, KOSCHI, classes (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/17/3/892/pdf (application/pdf)
https://www.mdpi.com/1660-4601/17/3/892/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:17:y:2020:i:3:p:892-:d:314860

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().