Table 2

Characteristics associated with undertriage of severely injured (ISS>15) children of all ages using multiple logistic regression analysis clustered on differential distance between distance from residence to primary triage hospital and distance from residence to nearest trauma center

CharacteristicMultiple Logistic Regression Model, Outcome of Under-triage
All agesAges 0–13
Odds Ratio (95% CL)P-valueOdds Ratio (95% CL)P-value
Age, years
 0–13reference
 0–364 daysNA0.86 (0.61–1.21)0.387
 1–3NA0.92 (0.62–1.37)0.685
 4–13NAreference
 14-<182.58 (2.1–3.16)<0.0001
Male sex0.9 (0.73–1.11)0.3240.93 (0.71–1.23)0.615
Race/Ethnicity
 White Non-Hispanicreferencereference
 Black Non-Hispanic1.27 (0.87–1.84)0.2181.1 (0.64–1.91)0.727
 Hispanic1.37 (1.1–1.72)0.0061.54 (1.12–2.1)0.008
 Asian, Pacific Islander0.92 (0.62–1.36)0.6710.75 (0.45–1.24)0.254
 Other or Missing1.02 (0.61–1.7)0.9481.17 (0.61–2.22)0.643
Payer
 Publicreferencereference
 Private1.93 (1.55–2.4)<0.00011.6 (1.17–2.2)0.003
 Private HMO*12.62 (8.95–17.79)<0.000117.8 (11.1–28.7)<0.0001
 Self-Insured2.43 (1.53–3.87)0.0014.2 (2.1–8.42)<0.0001
PatientCounty MSA† designation
 Urban (Large central metro)1.31 (1.02–1.67)0.0311.47 (1.05–2.05)0.026
 Suburban (Large fringe, Medium and Small metro)referencereference
 Rural Micropolitan/Noncore0.8 (0.48–1.33)0.3791.1 (0.48–2.53)0.829
TraumaCenterin County of Residence0.94 (0.74–1.2)0.6280.74 (0.53–1.03)0.077
Hospital size
 <200 bedsreferencereference
 200–399 beds3.76 (3.01–4.69)<0.00016.05 (4.31–8.49)<0.0001
 >400 beds3.64 (2.6–5.11)<0.00015.42 (3.37–8.73)<0.0001
Nonrural Hospital1.56 (1.08–2.27)0.0191.01 (0.55–1.88)0.965
Model Information
 c-statistic0.820.85
  • P values <0.05 were a priori designated as statistically significant. Model adjusted for year, body part injured, injury type and mechanism. designated as statistically significant. model adjusted for year, body part injured, injury type and mechanism.

  • *LEMSA: Local Emergency Medical Services Agency

  • †MSAMetropolitan Statistical Area