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Citation
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Allen CJ, Straker RJ, Tashiro J, Teisch LF, Meizoso JP, Ray JJ, Namias N, Sola JE. J. Surg. Res. 2015; 196(1): 1-7. |
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Abstract
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BACKGROUND: Our purpose was to analyze modern major vascular injury (MVI) patterns in pediatric trauma, interventions performed, and outcomes at a level 1 trauma center.
MATERIALS AND METHODS: From January 2000-December 2012, all pediatric admissions (<= 17 y) were reviewed.
RESULTS: Of 1928 pediatric admissions, 103 (5.3%) sustained MVI. This cohort was 85% male, age 15 +/- 3 y, 55% black, 58% penetrating, injury severity score of 23 +/- 15, with a length of stay of 8 (5) days. Firearm-related injury (47%) was the most common mechanism. Location of injuries included the extremities (50.5%), abdomen/pelvis (29.1%), and chest/neck (20.4%). Operative procedures included repair/bypass (71.4%), ligation (12.4%), amputation (10.5%), or temporary shunt (2.9%). Only three injuries (2.9%) were treated endovascularly. MVI patients had a mortality rate of 19.4%, higher than the overall pediatric trauma population of 3.5% (P < 0.001). After logistic regression, independent risk factors of mortality were vascular injury to the neck (odds ratio [OR]: 6.5; confidence interval (CI): 1.1-39.3), abdomen/pelvis (OR: 16.3; CI: 3.13-80.2), and chest (OR: 49.0; CI: 3.0-794.5).
CONCLUSIONS: MVI in children more commonly results from firearm-related injury. The mortality rate associated with MVI is profoundly higher than that of the overall pediatric trauma population. These findings underscore the major public health concern of firearm-related injury in children. (C) 2015 Elsevier Inc. All rights reserved.
Language: en |