Document Detail

Blunt intraabdominal arterial injury in pediatric trauma patients: injury distribution and markers of outcome.
MedLine Citation:
PMID:  18485966     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The epidemiology of pediatric blunt intraabdominal arterial injury is ill defined. We analyzed a multiinstitutional trauma database to better define injury patterns and predictors of outcome. METHODS: The American College of Surgeons National Trauma Database was evaluated for all patients younger than 16 years with blunt intraabdominal arterial injury from 2000 to 2004. Injury distribution, operative treatment, and variables associated with mortality were considered. RESULTS: One hundred twelve intraabdominal arterial injuries were identified in 103 pediatric blunt trauma patients. Single arterial injury (92.2%) occurred most frequently: renal (36.9%), mesenteric (24.3%), and iliac (23.3%). Associated injuries were present in 96.1% of patients (abdominal visceral, 75.7%; major extraabdominal skeletal/visceral, 77.7%). Arterial control was obtained operatively (n = 46, 44.7%) or by endovascular means (n = 6, 5.8%) in 52 patients. Overall mortality was 15.5%. Increased mortality was associated with multiple arterial injuries (P = .049), intraabdominal venous injury (P = .011), head injury (P = .05), Glasgow Coma Score less than 8 (P < .001), cardiac arrest (P < .001), profound base deficit (P = .007), and poor performance on multiple injured outcomes scoring systems (Revised Trauma Score [P < .001], Injury Severity Score [P = .001], and TRISS [P = .002]). CONCLUSION: Blunt intraabdominal arterial injury in children usually affects a single vessel. Associated injuries appear to be nearly universal. The high mortality rate is influenced by serious associated injuries and is reflected by overall injury severity scores.
Chad E Hamner; Jonathon I Groner; Donna A Caniano; John R Hayes; Brian D Kenney
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  43     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-19     Completed Date:  2008-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  916-23     Citation Subset:  IM    
Division of Pediatric General Surgery, Schneider Children's Hospital, New Hyde Park, NY 11040, USA.
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MeSH Terms
Abdomen / blood supply*
Abdominal Injuries / classification*,  epidemiology*,  mortality,  therapy
Arteries / injuries*
Puerto Rico / epidemiology
Survival Rate
Treatment Outcome
United States / epidemiology
Wounds, Nonpenetrating / classification*,  epidemiology*,  mortality,  therapy

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