Factors of parenchymal organ injury treatment outcome in children at Department of Pediatric Surgery, Split University Hospital Center during the 2000-2015 period

The aim of this study was to determine treatment outcome and survival in patients with blunt abdominal trauma. From January 2000 to January 2015, medical histories of patients treated for traumatic injury of parenchymal organs were retrospectively reviewed and the proportion of patients treated surgically or conservatively was estimated. In both categories, patients were divided into two groups of hemodynamically stable and hemodynamically unstable on admission. The following parameters were analyzed: gender, age, etiology, state of consciousness, and time from injury to admission. Regarding time to admission, patients were divided in those brought within the ‘golden hour’ and those brought beyond it. The Injury Severity Score (ISS) was calculated and the severity of injury assessed by Abbreviated Injury Scale (AIS). The values obtained were compared according to the etiology and state of consciousness, survival, and time to hospital admission. The study included 89 patients, most of them male, average age 11 years. There were 50.5% of polytrauma cases. Sixteen (17.9%) patients were treated with transfusion of blood products. Eighty-eight (98.8%) patients survived. Etiologically, most patients were injured by falling. Spleen was the most commonly injured organ and rupture was the most common type of injury. AIS and ISS were lower in patients brought within the ‘golden hour’ and those that were conscious at admission. The patient who did not survive was hemodynamically unstable, with associated injuries. Survival is infl uenced by hemodynamic stability at admission, AIS and ISS values, injuries of other organs in abdominal cavity and the rest of the body, state of consciousness at admission, and arrival within the ‘golden hour’. Hemodynamic stability, state of consciousness, AIS and ISS values were proved to be good predictors of survival after traumatic injuries of the abdomen. Key words: abdominal injuries; child; injury severity score; abbreviated injury scale; multiple trauma
Category: Original scientific paper
Volume: Vol. 60, No 4, october - december 2016
Authors: Ivo Jurić, Petra Smoje, Zenon Pogorelić, Davor Todorić, Miro Jukić, Dubravko Furlan
Reference work: Paediatr Croat. 2016;60:127-32
DOI: http://dx.doi.org/10.13112/PC.2017.19

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