Citation

Villamaria CY, Morrison JJ, Fitzpatrick CM, Cannon JW, Rasmussen TE. J. Pediatr. Surg. 2014; 49(3): 428-432.

Affiliation

59 MDW Wilford Hall Ambulatory Surgical Center, Lackland AFB, TX 78236, USA; United States Army Institute of Surgical Research, San Antonio, TX, USA. Electronic address: todd.e.rasmussen.mil@mail.mil.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.jpedsurg.2013.10.002

PMID

24650471

Abstract

BACKGROUND: Contemporary war-related studies focus primarily on adults with few reporting the injuries sustained in local pediatric populations. The objective of this study is to characterize pediatric vascular trauma at US military hospitals in wartime Iraq and Afghanistan.

METHODS: Review of the Department of Defense Trauma Registry (DoDTR) (2002-2011) identified patients (1-17years old) treated at US military hospitals in Iraq and Afghanistan using ICD-9 and procedure codes for vascular injury.

RESULTS: US military hospitals treated 4402 pediatric patients between 2002 and 2011. One hundred fifty-five patients (3.5%) had a vascular injury. Mean age, gender, and injury severity score (ISS) were 11.1±4.1years, 79% male, and 34±13.5, respectively. Vascular injuries were primarily from penetrating mechanisms (95.6%; 58.0% blast injury) to the extremity (65.9%), torso (25.4%), and neck (8.6%). Injuries were ligated (31%), reconstructed (63%), or observed (2%). Limb salvage rate was 95%. Mortality rate was 9%.

CONCLUSIONS: This study is the first to report vascular trauma in a pediatric population at wartime. Vascular injuries involve a high percentage of extremity and torso wounding. Torso vascular injury in children is four times lethal relative to other injury patterns, and therefore should be considered in operational planning both in the military and civilian setting regarding pediatric vascular injuries.

Language: en