Pediatric blunt abdominal injury

age is irrelevant and delayed operation is not detrimental.

Monika Tataria, Michael L. Nance, James H. Holmes, Charles C. Miller, Kelly D. Mattix, Rebeccah L. Brown, David P. Mooney, L. R Tres Scherer, Jon I. Groner, Eric R. Scaife, David A. Spain, Susan I. Brundage

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

BACKGROUND: During the past 40 years, management of solid organ injury in pediatric trauma patients has shifted to highly successful nonoperative management. Our purpose was to characterize children requiring operative intervention. We hypothesized that older children would be more likely to require operative intervention. In particular, we wanted to examine potential outcome disparities between children who were operated upon immediately and those in whom attempted nonoperative management failed. Additionally, we asked whether attempted nonoperative management, when failed, put children at higher risk for mortality or morbidities such as increased blood product transfusions or lengths of stays. METHODS: Retrospective cohorts from seven Level I pediatric trauma centers were identified. Blunt splenic, hepatic, renal, or pancreatic injuries were documented in 2,944 children 3 hours after arrival (n = 59; 42%). RESULTS: Comparing the two cohorts, no age differences were found. Compared with F-NOM, IO had significantly worse hemodynamics, Injury Severity Score, and Glasgow Coma Scale score and was associated with liver injuries. Pancreatic injuries were significantly associated with F-NOM. While controlling for injury severity to compare IO versus F-NOM, linear regression revealed equivalent blood transfusions, ICU LOS, hospital LOS, and mortality rates. CONCLUSION: IO and F-NOM are rare events and independent of age. When operated upon for appropriate physiology, the timing of operation in pediatric solid organ injury is irrelevant and not detrimental with respect to blood transfusion, mortality, ICU and hospital LOS, and resource utilization.

Original languageEnglish (US)
Pages (from-to)608-614
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume63
Issue number3
StatePublished - Sep 2007
Externally publishedYes

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Abdominal Injuries
Nonpenetrating Wounds
Pediatrics
Wounds and Injuries
Blood Transfusion
Hospital Mortality
Glasgow Coma Scale
Injury Severity Score
Mortality
Trauma Centers
Liver
Linear Models
Length of Stay
Hemodynamics
Morbidity
Kidney

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tataria, M., Nance, M. L., Holmes, J. H., Miller, C. C., Mattix, K. D., Brown, R. L., ... Brundage, S. I. (2007). Pediatric blunt abdominal injury: age is irrelevant and delayed operation is not detrimental. Journal of Trauma - Injury, Infection and Critical Care, 63(3), 608-614.

Pediatric blunt abdominal injury : age is irrelevant and delayed operation is not detrimental. / Tataria, Monika; Nance, Michael L.; Holmes, James H.; Miller, Charles C.; Mattix, Kelly D.; Brown, Rebeccah L.; Mooney, David P.; Scherer, L. R Tres; Groner, Jon I.; Scaife, Eric R.; Spain, David A.; Brundage, Susan I.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 63, No. 3, 09.2007, p. 608-614.

Research output: Contribution to journalArticle

Tataria, M, Nance, ML, Holmes, JH, Miller, CC, Mattix, KD, Brown, RL, Mooney, DP, Scherer, LRT, Groner, JI, Scaife, ER, Spain, DA & Brundage, SI 2007, 'Pediatric blunt abdominal injury: age is irrelevant and delayed operation is not detrimental.', Journal of Trauma - Injury, Infection and Critical Care, vol. 63, no. 3, pp. 608-614.
Tataria, Monika ; Nance, Michael L. ; Holmes, James H. ; Miller, Charles C. ; Mattix, Kelly D. ; Brown, Rebeccah L. ; Mooney, David P. ; Scherer, L. R Tres ; Groner, Jon I. ; Scaife, Eric R. ; Spain, David A. ; Brundage, Susan I. / Pediatric blunt abdominal injury : age is irrelevant and delayed operation is not detrimental. In: Journal of Trauma - Injury, Infection and Critical Care. 2007 ; Vol. 63, No. 3. pp. 608-614.
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abstract = "BACKGROUND: During the past 40 years, management of solid organ injury in pediatric trauma patients has shifted to highly successful nonoperative management. Our purpose was to characterize children requiring operative intervention. We hypothesized that older children would be more likely to require operative intervention. In particular, we wanted to examine potential outcome disparities between children who were operated upon immediately and those in whom attempted nonoperative management failed. Additionally, we asked whether attempted nonoperative management, when failed, put children at higher risk for mortality or morbidities such as increased blood product transfusions or lengths of stays. METHODS: Retrospective cohorts from seven Level I pediatric trauma centers were identified. Blunt splenic, hepatic, renal, or pancreatic injuries were documented in 2,944 children 3 hours after arrival (n = 59; 42{\%}). RESULTS: Comparing the two cohorts, no age differences were found. Compared with F-NOM, IO had significantly worse hemodynamics, Injury Severity Score, and Glasgow Coma Scale score and was associated with liver injuries. Pancreatic injuries were significantly associated with F-NOM. While controlling for injury severity to compare IO versus F-NOM, linear regression revealed equivalent blood transfusions, ICU LOS, hospital LOS, and mortality rates. CONCLUSION: IO and F-NOM are rare events and independent of age. When operated upon for appropriate physiology, the timing of operation in pediatric solid organ injury is irrelevant and not detrimental with respect to blood transfusion, mortality, ICU and hospital LOS, and resource utilization.",
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