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Pediatric vascular injuries: patterns of injury, morbidity, and mortality. J Pediatr Surg 2007 Jan;42(1):178-82; discussion 182-3

Date

01/09/2007

Pubmed ID

17208561

DOI

10.1016/j.jpedsurg.2006.09.016

Scopus ID

2-s2.0-33845957091   49 Citations

Abstract

PURPOSE: The purpose of this study was to identify the patterns of injury and associated morbidity/mortality related to pediatric vascular trauma.

METHODS: A retrospective review of children and adolescents treated between 1993 and 2005 was performed. Patients were identified by International Classification of Diseases, Ninth Revision codes within an institutional pediatric trauma registry.

RESULTS: One hundred seventy-six patients with vascular injury were identified. Those with injuries isolated to the digits and unspecified vessels were excluded (n = 73). The remaining 103 patients were evaluable and are the basis for subsequent comparisons. Seventy-four percent of injuries occurred in male patients. The average age of the male patients was 11.3 years and that of the female patients was 9.1 years (range, 1-18 years; overall, 10.7 years). Penetrating wounds caused 68% of the injuries, followed by blunt trauma (31%) and burns (0.97%). Anatomical locations of injury included the head/neck (19.4%), torso (13.5%), and extremities (67%). Amputation was required in 11 (10.7%) patients. The average hospital length of stay of the patients was 12.1 days (range, 1-155 days). The overall mortality was 9.7%. Nonoperative management was given to 9.7% of the patients; one death caused by carotid injury occurred. Overall, 24 patients underwent arteriography, with 1 patient receiving definitive treatment in interventional radiology. Of the 103 patients, 29.1% were managed by pediatric surgeons, 38.8% were managed by extremity specialists, 17% were managed by vascular surgeons, 5.8% were managed by neurosurgeons, and 9.3% were managed by others.

CONCLUSIONS: Despite the available multidisciplinary diagnostic and treatment modalities at tertiary care pediatric trauma centers, traumatic vascular injuries in children and adolescents are associated with significant morbidity and mortality in contemporary surgical practice.

Author List

Klinkner DB, Arca MJ, Lewis BD, Oldham KT, Sato TT

Authors

Brian D. Lewis MD Professor in the Surgery department at Medical College of Wisconsin
Keith T. Oldham MD Professor in the Surgery department at Medical College of Wisconsin
Thomas T. Sato MD Sr Associate Dean, CEO CSG, Professor in the Children's Specialty Group Administration department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Blood Vessels
Child
Child, Preschool
Female
Humans
Infant
Male
Registries
Retrospective Studies
Treatment Outcome
Wounds and Injuries
Wounds, Nonpenetrating
Wounds, Penetrating
jenkins-FCD Prod-387 b0ced2662056320369de4e5cd5f21c218c03feb3