The purpose of this study was to compare costs, admission rates, and outcomes for pediatric patients being evaluated in the emergency department after a motor vehicle collision (MVC) by whether the trauma team was activated or not.

This was a retrospective cross sectional study of all children that presented to the emergency department (ED) of an urban, tertiary children's hospital for evaluation within 24 hours of an MVC between the dates of 12/1/2015 and 11/30/2016. The primary endpoint was hospital charges. Secondary endpoints included hospital admission and return for missed injury within seven days. The primary exposure variable was trauma team activation, and the injury severity score was used to adjust for the confounding effect of level of injury. Linear and logistic regression were used to evaluate associations.

After exclusions, 556 total subjects remained for analysis, with 106 (19.1%) in the activation group.

The impact of a level 2 activation on the total hospital cost, after adjustment for injury severity, ranged from $15,106 to $3,504,862.20, with the majority of cases estimated to be $15,106 to $20,811. After adjusting for age and injury severity, subjects that had a level 2 trauma activation had an increased odds of hospital admission (aOR = 4.3, 95% CI: 2.0 to 9.2). One subject in the activation group and none in the non-activation group returned within 7 days for an injury not detected on the initial visit, suggesting similar quality of care between the groups.

In summary, in this study trauma team activation was associated with increased hospital costs and admission rates in low risk pediatric MVC patients, after adjustment for severity of injury. Additionally, there was no clear benefit to trauma team activation for these patients.