Pediatric Emergency Medicine Fellow UCSF Benioff Children's Hospital Oakland Santa Clara, California, United States
Background: Unintentional injury is the leading cause of ED visits and mortality in youth in the United States. Disparities exist in trauma care for ethnic minorities and patients with low SES. Immigration and Limited English Proficiency (LEP) status may further serve as a risk for disparities in trauma care for children, as this population is less educated and more likely to live in poverty. This study is the first of its kind to characterize unintentional injuries in LEP children, with the hope that this data will further inform us of interventions that could improve outcomes in immigrant children. Objective: Our primary objective is to investigate LEP status as a risk factor for disparities in the care of unintentional injuries in children < 5 years of age in the Bay Area, California. Specifically, we aim to describe the characteristics of these injuries, and to compare injury severity, resource utilization, and trauma outcomes between LEP children and English proficient (EP) children. Design/Methods: This is a retrospective cohort study using trauma registry data from a single Pediatric Level I Trauma Center. All children < 5 years of age who suffered an unintentional injury (based on ICD-9 and 10 codes) between 2014-2022 will be included. Cases will be excluded if there are coding abnormalities. Medical records will also be reviewed to gather data on preferred language, our independent variable. LEP status will be used as a proxy for immigration status, as our trauma registry does not collect immigration status.
Descriptive and comparative statistics will be used to report demographic and injury-related data for all children. Injury details will be compared, including injury time and location, first trauma phase, and injury severity. Resource utilization and trauma outcomes will also be studied. Multivariate logistic regression will be used to compare LEP relative to EP children in these different domains.
IRB approval was completed on 4/24/2023. Data cleaning will continue through 11/2023. Preliminary analyses will be completed by March 2024.
