Jeffrey S. Upperman, MD, director of the Trauma Program at Children's Hospital Los Angeles, has co-authored a call to action for filling a significant gap in pediatric public health care and seeks federal oversight to establish the framework for a pediatric applied trauma research network (PATRN).
This call to action was published simultaneously in the Journal of Pediatric Surgery and the Journal of Trauma.
"The establishment of a pediatric trauma research network will be an important advance in trauma care in the U.S.," said Dr. Upperman.
The societal costs of pediatric trauma are enormous. Because trauma is a disease process with identifiable and reproducible patterns, interventions can be developed to minimize its occurrence and to reduce its severity when trauma does occur. To make these changes, a pediatric trauma research network needs to be established to conduct research in this area in order to make evidence-based recommendations to improve the standard of care for this devastating pediatric health issue.
The World Health Organization established injury as the top pediatric public health problem in the world. Statistics for the United States support this finding with unintentional injury being the leading cause of death in young people from ages 1 to 24. National authorities have identified critical deficiencies in pediatric trauma care and insufficient research to address these deficiencies. Despite this enormous public health problem, there is no national pediatric trauma research network.
Pediatric trauma affects both sexes and all economic, racial, and social backgrounds. Children are injured in rural, suburban and urban environments. These injuries affect not only the physical well-being of the child but also the child's mental health and school performance, in addition to the well-being of the child's family. The societal cost of pediatric trauma due to lost years of productive life is enormous.
Because the number of seriously injured children treated at a single center is relatively small, and because an individual hospital is unlikely to have sufficient patient diversity, collaborative multicenter studies are required to address the differences in treatment of pediatric injury at trauma centers in diverse settings.
Collaborative networks for pediatric critical care and pediatric emergency care currently exist but only address specific sections of the care required by a pediatric trauma patient. The goal of PATRN is to address the critical unsolved problems that typically cross specialty boundaries including emergency transport to the hospital, emergency room care, pediatric surgery, neurosurgery, intensive care, physical therapy and rehabilitation. Establishment of a pediatric trauma network will enable cohesive care from admission to discharge for the patient with multisystem injuries.
The development of PATRN should include thought leaders from level 1 pediatric trauma centers from across the country. These subject matter expects will work with a panel of nationally recognized advisors to determine a research agenda. The National Institutes of Health, Center for Disease Control and Prevention, and Agency for Health Research and Quality are obvious choices to orchestrate and oversee the framework and infrastructure for this much needed network.
- Jeffrey S. Upperman, Randall Burd, Charles Cox, Peter Ehrlich, David Mooney, Jonathan I. Groner. Pediatric applied trauma research network: a call to action. Journal of Pediatric Surgery, 2010; 45 (11): 2278 DOI: 10.1016/j.jpedsurg.2010.08.059
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