Faculty Collaboration Database

The injured child is resistant to multiple organ failure: a different inflammatory response? J Trauma 2002 Dec;53(6):1058-63

Date

12/13/2002

Pubmed ID

12478028

DOI

10.1097/00005373-200212000-00005

Scopus ID

2-s2.0-0036899210 (requires institutional sign-in at Scopus site)   68 Citations

Abstract

BACKGROUND: Although postinjury multiple organ failure (MOF) is a well-described phenomenon in adults, the incidence of this syndrome in children is unknown. The purpose of this study was to describe the incidence, course, and severity of pediatric postinjury MOF. We hypothesized that the incidence and severity of postinjury MOF in children would be less when compared with adults.

METHODS: Patients were retrospectively identified from the trauma registry of a regional pediatric trauma center and an adult Level I trauma center with pediatric commitment for a 3-year period. All trauma patients less than 16 years old who survived for longer than 24 hours and had an Injury Severity Score > 15 were eligible. An accepted MOF score was used. Categorical variables were compared by chi2 and continuous variables by t test. A value of p< 0.05 was considered statistically significant.

RESULTS: Of 534 patients identified, 334 (63%) were admitted for evaluation of isolated head injury and excluded from further analysis. The rate of postinjury MOF in children was found to be only 3%, with a low (17%) mortality when compared with historical adult data (50%).

CONCLUSION: The incidence of postinjury MOF in the child is less than in the adult, given equivalent injury severity. These observations solidify the contention that postinjury MOF is rare in children, and is less severe when it occurs. Delineating the mechanism(s) whereby children are protected from postinjury MOF may provide insight into the development of strategies to prevent MOF in other age groups as well as various disease states.

Author List

Calkins CM, Bensard DD, Moore EE, McIntyre RC, Silliman CC, Biffl W, Harken AH, Partrick DA, Offner PJ

Author

Casey Matthew Calkins MD Professor in the Surgery department at Medical College of Wisconsin

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

Adolescent
Age Distribution
Analysis of Variance
Child
Critical Care
Female
Follow-Up Studies
Humans
Incidence
Injury Severity Score
Male
Multiple Organ Failure
Multiple Trauma
Probability
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Sex Distribution
Survival Analysis
Trauma Centers