Should Level I trauma centers be rated NC-17?

Background: Previous studies have contradictory reached conclusions regardi ng where injured children are best treated, Our hypothesis was that no diff erences in survival outcome exist among trauma centers caring for pediatric patients. Methods: For 16,108 injured children,we created a dependant variable, As-Ps (actual survival - predicted survival), which represents variation from TR ISS-predicted outcome for each individual. We them used that variable to co mpare trauma centers' survival results overall and results for liver, splee n, and head injuries, statistically adjusting for age and injury severity. Results: When adjusted for age and injury severity, centers with added qual ifications in pediatrics and Level I centers had improved survival performa nce overall and in the subcategory of head injured children. No differences existed in other organ-specific injury categories. Conclusion: The improved unexpected outcome results at Level I centers and centers with Added Qualifications in Pediatrics suggest that a team of qual ified professionals working in an institution willing to commit the require d resources can sufficiently offer injured children the survival advantage expected of a trauma center.