Pediatric XXXX in the US: epidemiology and disparities.

@entity3510 @entity1 @entity174 @entity1566 @entity130
UNASSIGNED: OBJECT In the US, race and economic status have pervasive associations with mechanisms of injury, severity of injury, management, and outcomes of @entity130 . The goal of the current study was to examine these relationships on a large scale in the setting of pediatric @entity3510 . METHODS Admissions for @entity174 without or with @entity1566 ( @entity1566 ), spinal dislocation, and @entity1566 without radiographic abnormality were identified in the Kids' Inpatient Database (KID) and the National @entity130 Data Bank (NTDB) registry for 2009. @entity1 ranged in age from birth up to 21 years. Data from the KID were used to estimate nationwide annual incidences. Data from the NTDB were used to describe patterns of injury in relation to age, race, and payor, with corroboration from the KID. Multiple logistic regression was used to model rates of mortality and spinal fusion. RESULTS In 2009, the estimated incidence of hospital admission for @entity3510 in the US was 170 per 1 million in the population under 21 years of age. The incidence of @entity1566 was 24 per 1 million. Incidences varied regionally. Adolescents predominated. Patterns of injury varied by age, race, and payor. Black @entity1 were more severely injured than @entity1 of other races as measured by Injury Severity Scale scores. Among black @entity1 with @entity3510 in the NTDB, 23.9% suffered @entity130 ; only 1% of white @entity1 suffered @entity130 . The overall mortality rate in the NTDB was 3.9%. In a multivariate analysis that included a large panel of clinical and nonclinical factors, black race retained significance as a predictor of mortality (p = 0.006; adjusted OR 1.571 [1.141-2.163]). Rates of spinal fusion were associated with race and payor in the NTDB data and with payor in the KID: @entity1 with better insurance underwent spinal fusion at higher rates. CONCLUSIONS The epidemiology of pediatric @entity3510 in the US cannot be understood apart from considerations of race and economic status.
