Faculty Collaboration Database

Utility of radiographic hepatic injury grade in predicting outcome for children after blunt abdominal trauma. J Pediatr Surg 2002 Mar;37(3):386-9

Date

03/06/2002

Pubmed ID

11877653

DOI

10.1053/jpsu.2002.30822

Scopus ID

2-s2.0-0036190963 (requires institutional sign-in at Scopus site)   35 Citations

Abstract

BACKGROUND/PURPOSE: The American Association for the Surgery of Trauma (AAST) liver injury grading system has been adopted in the management of pediatric hepatic injuries. However, the usefulness of this grading system in children remains undefined. The authors, therefore, examined the validity of AAST grading in the management of pediatric blunt liver injury.

METHODS: The authors identified 152 patients, ages 0 to 18 years, with blunt hepatic injury treated at our pediatric trauma center between 1995 and 2000. Radiographic AAST grade was assigned retrospectively by 2 radiologists. Variables analyzed included age, gender, Glasgow Coma Score (GCS), Injury Severity Score (ISS), and associated injuries. Outcome measures were mortality rate and length of stay (LOS). Statistical analysis was performed using analysis of variance or linear regression.

RESULTS: Computed tomography (CT) scans were available for 95 patients. Radiographic injury grade did not correlate with mortality rate, hospital LOS or intensive care unit (ICU) LOS. ISS and associated injury, but not age, gender, or GCS, were predictive of LOS. Grade did not correlate with mortality rate, ICU LOS, or hospital LOS.

CONCLUSIONS: Radiographic liver grading does not predict outcome reliably in children and should not be the main parameter utilized to guide clinical decision making. A role for scoring systems that utilize factors such as associated injuries and ISS is indicated.

Author List

Hackam DJ, Potoka D, Meza M, Pollock A, Gardner M, Abrams P, Upperman J, Schall L, Ford H

Author

Laura Cassidy PhD Associate Dean, Professor in the Institute for Health and Equity department at Medical College of Wisconsin

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

Abdominal Injuries
Adolescent
Child
Child, Preschool
Female
Glasgow Coma Scale
Humans
Infant
Infant, Newborn
Injury Severity Score
Liver
Male
Predictive Value of Tests
Prognosis
Retrospective Studies
Tomography, X-Ray Computed
Wounds, Nonpenetrating