Reduction of in-hospital mortality after implementation of a pediatric trauma unit for children with moderate and severe trauma at Baca Ortiz Children's Hospital. Quito–Ecuador

Pediatric trauma is one of the leading causes of childhood morbidity and mortality worldwide. Optimizing early management in specialized units may substantially improve survival and functional outcomes. We therefore evaluated the impact of implementing a specialized Pediatric Trauma Unit on in-hospital mortality among children with moderate and severe trauma at Baca Ortiz Children's Hospital (HPBO) in Quito, Ecuador. Methods We conducted a retrospective cohort study with historical controls including pediatric patients with moderate or severe trauma admitted before ( n = 104) and after ( n = 183) implementation of the Pediatric Trauma Unit. Descriptive statistics were used to summarize demographic and clinical characteristics. Chi-square and Fisher's exact tests were applied to compare categorical variables. Logistic regression was performed to assess the association between unit implementation and in-hospital mortality, adjusting for clinical severity scores and other potential confounders. Results In-hospital mortality decreased from 16.3% in the pre-implementation period to 3.3% after implementation of the Pediatric Trauma Unit. Unit implementation was associated with an 88% reduction in the odds of death (adjusted OR 0.12; 95% CI 0.04–0.36; p < 0.001). Deceased patients had significantly higher pre-implementation BIG scores than survivors ( p = 0.02). Survival among patients with abdominal trauma also improved after protocol implementation ( p = 0.01). Conclusions Implementation of a specialized Pediatric Trauma Unit at Baca Ortiz Children's Hospital was associated with a marked reduction in in-hospital mortality among children with moderate and severe trauma. These findings support the development and strengthening of pediatric trauma care systems in similar settings.