Pediatric vascular injury: Experience of a level 1 trauma center

Casey J. Allen, Richard J. Straker, Jun Tashiro, Laura F. Teisch, Jonathan P. Meizoso, Juliet J. Ray, Nicholas Namias, Juan E Sola

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalJournal of Surgical Research
Volume196
Issue number1
DOIs
StatePublished - Jun 1 2015

Keywords

  • Children
  • Firearms
  • Injury patterns
  • Mortality
  • Outcomes

ASJC Scopus subject areas

  • Surgery

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    Allen, C. J., Straker, R. J., Tashiro, J., Teisch, L. F., Meizoso, J. P., Ray, J. J., Namias, N., & Sola, J. E. (2015). Pediatric vascular injury: Experience of a level 1 trauma center. Journal of Surgical Research, 196(1), 1-7. https://doi.org/10.1016/j.jss.2015.02.023