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A National Database Perspective on Pediatric Non-Accidental Trauma Patients and Differential Outcomes for Facial Trauma Operations Performed by Otolaryngologists and Plastic Surgeons
Joseph W. Mocharnuk, BA, Anne Glenney, BA, Dana Meshkin, BSN, Jesse A. Goldstein, MD, Miles J. Pfaff, MD, Raj M. Vyas, MD
University of Pittsburgh School of Medicine
2023-02-10
Presenter: Joseph Mocharnuk
Affidavit:
Joseph Mocharnuk
Director Name: Vu Nguyen, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Purpose
The Pediatric Health Information System (PHIS) database collects admissions, diagnostic, and treatment data among 44 children's hospitals across the U.S. Non-accidental trauma (NAT) is a prominent cause of trauma mortality in the pediatric population. However, little has been published on national outcomes for NAT cases shared by otolaryngologists and plastic surgeons and their interplay with measures of the social determinants of health (i.e., the Child Opportunity Index or COI). The purpose of this study is to explore this relationship among a subset of NAT patients who underwent these shared facial trauma procedures.
Methods
A retrospective review was performed after querying the PHIS database for ICD codes pertaining to pediatric non-accidental trauma.
Results
Among the 179,688 NAT cases included in PHIS, 4,462 were associated with facial trauma operations performed by plastic surgeons and otolaryngologists. Of these procedures, 2,741 had an otolaryngologist as treating physician, and 1,721 had a plastic surgeon treating physician. The average COI of patients of otolaryngologist-treated patients (44.3 ± 2.4) was significantly higher (p-value <0.0001) than plastic-surgeon-treated patients (mean COI: 28.9 ± 3.1), indicating increased socioeconomic strain. Controlling for this difference in COI, the average length of stay among plastic surgeons for the same subset of procedures was significantly lower by an average of 3.89 days (p-value <0.0001) compared to otolaryngologists.
Conclusion
This study offers a national perspective on the relationship between social determinants of health and length of stay in pediatric non-accidental trauma patients who underwent procedures for facial trauma that are performed by both otolaryngologists and plastic surgeons.
