Eur J Trauma Emerg Surg. 2021 Apr 03; doi: 10.1007/s00068-021-01658-4. Epub 2021 Apr 03.
Characteristics of pediatric thoracic trauma: in view of before and after the establishment of a regional trauma center.
European journal of trauma and emergency surgery : official publication of the European Trauma Society
Pil Young Jung, Jae Sik Chung, Youngin Youn, Chang Wan Kim, Il Hwan Park, Oh Hyun Kim, Chun Sung Byun
Affiliations
Affiliations
- Regional Trauma Center, Wonju Severance Christian Hospital, Wonju, Republic of Korea.
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
- Department of Thoracic and Cardiovascular Surgery, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon, 26426, Republic of Korea.
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
- Department of Thoracic and Cardiovascular Surgery, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon, 26426, Republic of Korea. [email protected].
PMID: 33813596
PMCID: PMC8019336 DOI: 10.1007/s00068-021-01658-4
Abstract
PURPOSE: Pediatric thoracic trauma differs from those of adult in terms of the small anatomy and rapid tissue recovery. Therefore, it is important to know the characteristics of the pediatric thoracic trauma to improve treatment results. In addition, this study examined the changes in pediatric thoracic trauma features and results from the establishment of a level 1 regional trauma center.
METHODS: Data of 168 patients' ≤ 15 years old diagnosed with thoracic trauma between 2008 and 2019 were retrospectively analyzed.
RESULTS: Pedestrian traffic accidents were the most common cause of chest injury. The average injury severity score was 17.1 ± 12.4 and the average pediatric trauma score was 5.6 ± 4.1. Lung contusion was the most common in 134 cases. There were 48 cases of closed thoracostomy. There was one thoracotomy for cardiac laceration, one case for extracorporeal membranous oxygenation, and six cases for embolization. Of all, 25 patients died, providing a mortality rate of 14.9%. In addition, independent risk factors of in-hospital mortality were hemopneumothorax and cardiac contusion. Since 2014, when the level 1 regional trauma center was established, more severely injured thoracic trauma patients came. However, the mortality was similar in the two periods.
CONCLUSIONS: Understanding the clinical features of pediatric thoracic trauma patients can help in efficient treatment. In addition, as the severity of pediatric thoracic trauma patients has increased due to the establishment of the regional trauma center, so pediatric trauma center should be organized in regional trauma center to improve the outcomes of pediatric thoracic trauma.
Keywords: Injury severity score; Pediatric; Thoracic injury; Thoracic trauma; Trauma center
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