Management of Children and Adolescents with Chest Trauma in Pediatric and Non-Pediatric Departments-A Claims Data Analysis.

Background: To investigate the management of children and adolescents with isolated and combined chest trauma in pediatric (PD) and non-pediatric departments (non-PD).

Methods: Anonymized claims data were provided by two large German statutory health insurance funds, covering 6.3 million clients over a 10-year period (2010-2019). Data were extracted for patients who had an inpatient ICD diagnosis of section S20-S29 (injuries to the thorax) and were ≤18 years of age. Demographic and clinical data were analyzed.

Results: A total of 4064 children and adolescents with chest trauma were included (mean age 12.0 ± 5.0 years; 55% male). In 1928 cases (47.4%), treatment was provided at PD. Patients admitted to PD underwent CT imaging less frequently (8.1%; non-PD: 23.1%; < 0.0001). Children with a chest drain treated at university/maximum care hospitals (UM) showed more injuries involving multiple body regions compared with non-UM (25.8% vs. 4.5%; = 0.0061) without a difference in the length of hospital stay.

Conclusion: Children and adolescents with chest trauma are treated almost equally often in pediatric and adult departments. CT is significantly less frequently used in pediatric departments. Patients with a chest drain treated at a UM showed more concomitant injuries without a longer hospital stay. However, the clinical validity of this finding is questionable.