<< Back to the abstract archive
Maximizing Patient Benefit in Interfacility Transfer for the Management of Pediatric Hand Trauma
Darya Fadavi, MD; Anne E. Glenney, BA; Meeti Mehta, BS; Zainab Balogun, BS; Vivian Wang, BA; Shirley Liu, BA; Lucille G. Cheng, BA; Alexander Davit, MD
University of Pittsburgh Medical Center (UPMC)
2023-02-10
Presenter: Darya Fadavi
Affidavit:
Vu Nguyen
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Background:
Transfer to specialized centers is common in pediatric hand trauma patients. These transfers can significantly reduce patient morbidity, but when specialized care is not indicated, often place undue burden on families to travel outside their communities while diverting resources from urgent cases. Our project aims to identify factors associated with patient transfer in pediatric hand trauma, in order to contribute to a decision-making algorithm for maximizing patient benefit in interfacility transfer for hand trauma.
Methods:
A retrospective review was performed of patients under 18 years of age who were evaluated for hand trauma at a pediatric level I trauma center between 2010 and 2020. Variables studied included demographics, etiology, medical history, associated injuries, treatments, and outcomes. Factors associated with increased likelihood of transfer were identified.
Results:
A total of 1151 patients met inclusion criteria; 308 (26.8%) were transferred from an outside institution. Scaphoid fractures (RR 7.63, CI 1.80-72.58), index finger injuries (RR 1.57, CI 1.01-2.43), and fingertip injuries (RR 1.62, 1.08-2.44) were associated with a higher likelihood of transfer (p<0.04). Motorized vehicle accidents (MVA), and animal bites were also associated with increased risk of transfer (RR 6.06, CI 1.90-19.35, p<0.001; RR 13.47, CI 1.59-114.25, p=0.002, respectively). Finally, rural geography was associated with 2.89 times greater risk of transfer (RR 2.89, CI 1.67-5.02, p<0.001).
Conclusion:
Pediatric hand trauma is one of the most common causes of ED visits in the U.S. each year. Fracture type, mechanism of injury, and geography all influence likelihood of patient transfer in pediatric hand trauma.
