New Technology Dependence Among Children Hospitalized for Traumatic Injury.

Abstract

We aimed to determine the frequency of, and factors associated with, new technology dependence among hospitalized pediatric trauma survivors. We performed a retrospective cross-sectional study of encounters from over 800 US hospitals using the 2021 and 2022 American College of Surgeons National Trauma Data Bank Trauma Quality Improvement Program files. We included children younger than 18 years hospitalized for trauma who survived to discharge. We performed multivariable logistic regression to determine the effect of exposures including injury mechanism and serious injuries on our primary outcome of interest, the performance of a procedure conferring technology dependence as defined by the Pediatric Complex Chronic Condition System Version 3. Secondary outcomes included hospital length of stay, complications, and discharge disposition. Among 183 848 hospitalized pediatric trauma survivors (median age: 10 years, 64.1% male), 2.0% underwent a procedure conferring new technology dependence. Firearm (odds ratio [OR] 3.8) and traffic injuries (OR 2.4) were associated with new technology dependence, and serious injuries to all but 1 body system (extremities) were associated with new technology dependence, particularly head and neck injuries (OR 9.2). The most common procedure types were spinal fusion (41.0%), cerebrospinal fluid drainage (27.6%), and feeding device placement (27.6%). Children with new technology dependence experienced longer hospital stays, more complications, and were less frequently discharged home without services. One in 50 hospitalized pediatric trauma survivors underwent procedures conferring new technology dependence. These findings underscore the need for trauma-informed survivorship care and prevention strategies that address the chronic health consequences of childhood injury.