Characteristics of severely injured (ISS>15) children with primary triage to an adult non-trauma center, and those subsequently undertriaged in California from 2005 to 2015 (N=15 656)
| Characteristic | Grand total | Trauma center | Adult non-trauma center | Undertriage* |
| N | 15 656 | 12 251 (78.3%) | 3405 (21.7%) | 1866 (11.9%) |
| Age category | ||||
| Age median (IQR) | 12.8 (4.1–16.2) | 12.8 (4.1–16.3) | 13.0 (4.0–16.2) | 14.6 (7.0–16.7) |
| 0–364 days | 2027 (12.9%) | 1551 (12.7%) | 476 (14.0%) | 207 (11.1%) |
| 1–3 years | 1287 (8.2%) | 1022 (8.3%) | 265 (7.8%) | 104 (5.6%) |
| 4–13 years | 5441 (34.8%) | 4290 (35.0%) | 1151 (33.8%) | 536 (28.7%) |
| 14-<18 years | 6901 (44.1%) | 5388 (44.0%) | 1513 (44.4%) | 1019 (54.6%) |
| Gender | ||||
| Female | 4662 (29.8%) | 3719 (30.4%) | 943 (27.7%) | 489 (26.2%) |
| Male | 10 991 (70.2%) | 8529 (69.6%) | 2462 (72.3%) | 1377 (73.8%) |
| Race/ethnicity | ||||
| White non-Hispanic | 5228 (33.4%) | 3770 (30.8%) | 1458 (42.8%) | 755 (40.5%) |
| Black non-Hispanic | 1233 (7.9%) | 989 (8.1%) | 244 (7.2%) | 143 (7.7%) |
| Hispanic | 6769 (43.2%) | 5498 (44.9%) | 1271 (37.3%) | 722 (38.7%) |
| Asian, Pacific Islander | 802 (5.1%) | 592 (4.8%) | 210 (6.2%) | 113 (6.1%) |
| Other | 837 (5.3%) | 725 (5.9%) | 112 (3.3%) | 57 (3.1%) |
| Missing | 787 (5.0%) | 677 (5.5%) | 110 (3.2%) | 76 (4.1%) |
| Payer status | ||||
| Public | 8481 (54.2%) | 7170 (58.5%) | 1311 (38.5%) | 491 (26.3%) |
| Private | 4835 (30.9%) | 3668 (29.9%) | 1167 (34.3%) | 646 (34.6%) |
| Private HMO | 1710 (10.9%) | 926 (7.6%) | 784 (23.0%) | 643 (34.5%) |
| Self | 522 (3.3%) | 394 (3.2%) | 128 (3.8%) | 78 (4.2%) |
| Length of stay | ||||
| Days, median (IQR) | 4 (2–9) | 4 (2–10) | 3 (2–6) | 3 (1–6) |
| Mortality | ||||
| Died | 915 (5.8%) | 774 (6.3%) | 141 (4.1%) | 87 (4.7%) |
| Died <48 hours. | 566 (3.6%) | 475 (3.9%) | 91 (2.7%) | 60 (3.2%) |
| Trauma center in LEMSA of residence | 14 762 (94.3%) | 12 110 (98.8%) | 2652 (77.9%) | 1514 (81.1%) |
| Patient county MSA designation | ||||
| Urban (large central metro) | 9177 (58.6%) | 7445 (60.8%) | 1732 (50.9%) | 1163 (62.3%) |
| Suburban (large fringe, medium and small metro) | 6096 (38.9%) | 4577 (37.4%) | 1519 (44.6%) | 661 (35.4%) |
| Rural (micropolitan/non-core) | 383 (2.4%) | 229 (1.9%) | 154 (4.5%) | 42 (2.3%) |
| Distance to hospital in miles, median (IQR) | ||||
| From zip code of residence to trauma center | 7.4 (3.6–18.4) | 6.5 (3.4–15.1) | 12.4 (5.9–25.8) | 10.3 (5.1–22.7) |
| From zipcode of residence to Primary Triage Hospital | 9.5 (4–22.5) | 10.5 (5–26) | 5.5 (2.5–12) | 7.5 (3–15.5) |
| Hospital size | ||||
| <200 beds | 2316 (14.8%) | 962 (7.9%) | 1354 (39.8%) | 457 (24.5%) |
| 200–399 beds | 6813 (43.5%) | 5264 (43.0%) | 1549 (45.5%) | 1033 (55.4%) |
| >400 beds | 6477 (41.4%) | 6012 (49.1%) | 465 (13.7%) | 361 (19.3%) |
| LOS in days, median (IQR) | 4 (2–9) | 4 (2–10) | 3 (2–6) | 3 (1–6) |
*Undertriage’ is a subset of those triaged to an adult non-trauma center and are not part of grand total
HMO, Health Maintenance Organization; ISS, Injury Severity Score; LEMSA, Local Emergency Medical Services Agency; LOS, length of stay; MSA, Metropolitan Statistical Area.