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Mortality after emergency department thoracotomy for pediatric blunt trauma: Analysis of the National Trauma Data Bank 2007-2012. J Pediatr Surg 2016 Jan;51(1):163-7

Date

11/19/2015

Pubmed ID

26577911

DOI

10.1016/j.jpedsurg.2015.10.034

Scopus ID

2-s2.0-84952990685   12 Citations

Abstract

PURPOSE: The purpose of this study was to determine the proportion of children who survived after emergency department thoracotomy (EDT) for blunt trauma using a national database.

METHODS: A review of the National Trauma Data Bank was performed for years 2007-2012 to identify children <18 years of age who underwent EDT for blunt trauma.

RESULTS: Eighty-four children <18 years of age underwent EDT after blunt trauma. Every child died during their hospitalization. The median age was 15 (IQR 6-17) years. Mean injury severity score (ISS) was 34.2 (SD 20.8), and 56% had an ISS of 26-75. Data for "signs of life" were available for 21 children. Fifteen (71%) had signs of life upon ED arrival. Sixty percent of children died in the ED. Of those who survived to the operating room (OR), 66% died in the OR. Four children (5%) survived more than 24 hours in the intensive care unit, three of whom had a maximum head abbreviated injury score of 5.

CONCLUSION: There were no survivors after EDT for blunt trauma in the pediatric population in this national dataset. Usual indicators for EDT after blunt trauma in adults may not apply in children, and use should be discouraged without compelling evidence of a reversible cause of extremis.

Author List

Flynn-O'Brien KT, Stewart BT, Fallat ME, Maier RV, Arbabi S, Rivara FP, McIntyre LK

Author

Katherine T. Flynn-O'Brien MD, MPH Assistant Professor in the Surgery department at Medical College of Wisconsin




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

Adolescent
Child
Craniocerebral Trauma
Databases, Factual
Emergency Service, Hospital
Female
Hospital Mortality
Humans
Injury Severity Score
Male
Retrospective Studies
Thoracic Injuries
Thoracotomy
United States
Wounds, Nonpenetrating