THE RELATIONSHIPS OF SKELETAL INJURIES WITH TRAUMA SCORE, INJURY SEVERITY SCORE, LENGTH OF HOSPITAL STAY, HOSPITAL CHARGES, AND MORTALITY IN CHILDREN ADMITTED TO A REGIONAL PEDIATRIC TRAUMA CENTER

Thirty-four-hundred and seventy-two children were consecutively admitt ed for acute traumatic injuries over a 34 month period to the Children 's National Medical Center. The study comprised 805 patients who susta ined 953 fractures and dislocations. The male to female ratio was 2:1. Age at the time of admission was evenly distributed over 16 years, wi th a mean of 8.3 years. Pedestrian accidents and falls each accounted for 34% of the musculoskeletal injuries, whereas motor vehicle acciden ts accounted for an additional 13%. The femur was the most commonly fr actured bone, representing 22% of all fractures and dislocations, foll owed by the humerus (16%), tibia/fibula (12%), ankle/foot (13%), and r adius/ulna (8%). Nine percent of the fractures were open. The average length of hospital stay was 8.6 days, and the average cost per hospita l admission was $8,765. The mortality rate was 3%. Central musculoskel etal injuries (spine, clavicle/scapula, and pelvis) in our hospitalize d patients were associated with the longest hospital stays and intensi ve care unit admissions, and lowest Trauma Scores, as well as the high est Injury Severity Scores, hospital charges, and mortality rates.