Table 1

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)

CharacteristicGrand totalTrauma centerAdult non-trauma centerUndertriage*
N15 65612 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 days2027 (12.9%)1551 (12.7%)476 (14.0%)207 (11.1%)
 1–3 years1287 (8.2%)1022 (8.3%)265 (7.8%)104 (5.6%)
 4–13 years5441 (34.8%)4290 (35.0%)1151 (33.8%)536 (28.7%)
 14-<18 years6901 (44.1%)5388 (44.0%)1513 (44.4%)1019 (54.6%)
Gender
 Female4662 (29.8%)3719 (30.4%)943 (27.7%)489 (26.2%)
 Male10 991 (70.2%)8529 (69.6%)2462 (72.3%)1377 (73.8%)
Race/ethnicity
 White non-Hispanic5228 (33.4%)3770 (30.8%)1458 (42.8%)755 (40.5%)
 Black non-Hispanic1233 (7.9%)989 (8.1%)244 (7.2%)143 (7.7%)
 Hispanic6769 (43.2%)5498 (44.9%)1271 (37.3%)722 (38.7%)
 Asian, Pacific Islander802 (5.1%)592 (4.8%)210 (6.2%)113 (6.1%)
 Other837 (5.3%)725 (5.9%)112 (3.3%)57 (3.1%)
 Missing787 (5.0%)677 (5.5%)110 (3.2%)76 (4.1%)
Payer status
 Public8481 (54.2%)7170 (58.5%)1311 (38.5%)491 (26.3%)
 Private4835 (30.9%)3668 (29.9%)1167 (34.3%)646 (34.6%)
 Private HMO1710 (10.9%)926 (7.6%)784 (23.0%)643 (34.5%)
 Self522 (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
 Died915 (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 residence14 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 center7.4 (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 Hospital9.5 (4–22.5)10.5 (5–26)5.5 (2.5–12)7.5 (3–15.5)
Hospital size
 <200 beds2316 (14.8%)962 (7.9%)1354 (39.8%)457 (24.5%)
 200–399 beds6813 (43.5%)5264 (43.0%)1549 (45.5%)1033 (55.4%)
 >400 beds6477 (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.