Presenter Profile
Romeo C. Ignacio, MD, MS, MPath, FACS, FAAP
University of California San Diego School of Medicine
Trauma Medical Director, Department of Trauma
Chief, Section in Pediatric Surgery
Rady Children's Hospital San Diego
r1ignacio@health.ucsd.edu
CAPT (Ret.) Romeo C. Ignacio is a veteran who served in the U.S. Navy for 24 years. He is a Clinical Professor of Surgery at the University of California San Diego School of Medicine and an academic pediatric surgeon at Rady Children’s Hospital in San Diego (RCHSD). Dr. Ignacio serves as the Trauma Medical Director, Chief - Section in Pediatric Surgery, and the Director of Clinical Research program for the Division of Pediatric Surgery at Rady Children’s Hospital San Diego. He has been recently nominated as a Central Member of the American College of Surgeons (ACS) Committee on Trauma and the ACS Chapter California Medical Associates delegate. He has over 90 peer-reviewed articles, 190 presentations, and is the co-editor of the textbook, Pediatric Trauma Care. His research and advocacy work has involved window falls, bicycle/e-bike injuries, drownings, and healthcare disparities in pediatric trauma.
Presentations
A Window of Opportunity: Understanding Pediatric Falls Using Area Deprivation Index
Víctor de Cos, BS
Anthony Galvez, BA
Alexandra S. Rooney, MA
Alicia Sykes, MD
Andrea Krzyzaniak, MA
David Lazar, MD
Hari Thangarajah, MD, MPH
Vishal Bansal, MD
Michael Sise, MD
Romeo C. Ignacio, MD, MS, MPath, FACS, FAAP
The purpose of our study is to assess neighborhood socioeconomic disadvantage (NSD) as a risk factor for window falls (WF) in children.
A single institution retrospective review was performed of patients ?18 years old with fall injuries treated at a Level I trauma center between 2018 and 2021. Demographic, injury, and NSD characteristics which were collected from a trauma registry were analyzed and compared between WF versus non-window falls. Area Deprivation Index (ADI) was used to measure NSD levels based on patients' home address 9-digit zip code, with greater NSD being defined as ADI quintiles 4 and 5. Property type was used to compare falls that took place at single-family homes versus apartment buildings
Among 1545 pediatric fall injuries, 194 were WF, of which 60 % were male and 46 % were Hispanic. WF patients were younger than NWF patients (median age WF 3.2 vs. age 4.3, p<0.047). WF patients were more likely to have a depressed Glasgow Coma Scale (GCS score ?12, WF 9 % vs. 3 %) and sustain greater head/neck injuries (median AIS 3vs. AIS 2, p<0.001) when compared to NWF. WF patients had longer hospital and ICU lengths of stay than NWF patients (p<0.001 and p<0.001, respectively). WF patients were more likely to live in areas of greater NSD than NWF patients (53 % vs. 35 %, p<0.001), and 73 % of all WF patients lived in apartments or condominiums.
Window fall injuries were associated with lower GCS, greater severity of head/neck injuries, and longer hospital and ICU length of stay than non-window falls. ADI research can provide meaningful data for targeted injury prevention programs in areas where children are at higher risk of window falls.
1. The definition of Area Deprivation Index
2. The association of area deprivation of index to window fall in children
3. How ADI can be used for targeted injury prevention programs