Thoracic Injuries in Pediatric Polytraumatized Patients: Epidemiology, Treatment and Outcome
| Autor: | Julian Joestl, Roman C. Ostermann, Thomas M. Tiefenboeck, Patrick Platzer, Marcus Hofbauer, Nikolaus W. Lang, Sylvina Ohnesorg |
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| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Adolescent Thoracic Injuries Logistic regression 03 medical and health sciences Injury Severity Score 0302 clinical medicine Epidemiology medicine Humans Glasgow Coma Scale Child Pathological Retrospective Studies General Environmental Science 030222 orthopedics business.industry 030208 emergency & critical care medicine Retrospective cohort study Evidence-based medicine medicine.disease Polytrauma Treatment Outcome Concomitant Cohort General Earth and Planetary Sciences business |
| Zdroj: | Injury. 52:1316-1320 |
| ISSN: | 0020-1383 |
| DOI: | 10.1016/j.injury.2021.02.033 |
| Popis: | The purpose of the present study was to assess the influence and contribution, epidemiology, treatment and outcome of thoracic injuries in a cohort of pediatric and adolescent polytraumatized patients.All pediatric and adolescent (age18 years) polytraumatized patients with associated thoracic injuries were included in this study. Demographic data, mechanism of injury (MOI), injury severity score (ISS), Glasgow Coma Scale (GCS), hemodynamic parameters and pupillary response at ED admission, site of major injury (SOMI), associated chest and non-chest related injuries, length of hospital stay (LOS), procedures performed at the ED as well as outcome variables including mortality and cause of death. Stepwise logistic regression analysis was used to identify risk factors for a poor prognosis and outcome.The logistic regression found the following variables decreasing the odds for a "bad outcome": lack of a hemodynamically unstable condition (p = 0.009) and the absence of a pathological pupillary response (p0.001).The present study suggests that the severity of concomitant chest injuries in polytraumatized pediatric and adolescent patients contributes substantially to morbidity and mortality. Due to the anatomic features of the immature pediatric bones, careful attention should be drawn to possible severe chest injuries even in the absence of rib fractures.A retrospective study (level - IV study). |
| Databáze: | OpenAIRE |
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