Title

Outcomes of truncal vascular injuries in children.

Publication Date

10-1-2009

Journal

J Pediatr Surg. 2009 October; 44(10): 1958–1964.

Abstract

BACKGROUND: Pediatric truncal vascular injuries occur infrequently and have a reported mortality rate of 30% to 50%. This report examines the demographics, mechanisms of injury, associated trauma, and outcome of patients presenting for the past 10 years at a single institution with truncal vascular injuries.

METHODS: A retrospective review (1997-2006) of a pediatric trauma registry at a single institution was undertaken.

RESULTS: Seventy-five truncal vascular injuries occurred in 57 patients (age, 12 +/- 3 years); the injury mechanisms were penetrating in 37%. Concomitant injuries occurred with 76%, 62%, and 43% of abdominal, thoracic, and neck vascular injuries, respectively. Nonvascular complications occurred more frequently in patients with abdominal vascular injuries who were hemodynamically unstable on presentation. All patients with thoracic vascular injuries presenting with hemodynamic instability died. In patients with neck vascular injuries, 1 of 2 patients who were hemodynamically unstable died, compared to 1 of 12 patients who died in those who presented hemodynamically stable. Overall survival was 75%.

CONCLUSIONS: Survival and complications of pediatric truncal vascular injury are related to hemodynamic status at the time of presentation. Associated injuries are higher with trauma involving the abdomen.

Keywords

Abdominal Injuries, Adolescent, Anastomosis, Surgical, Blood Vessels, Cause of Death, Child, Hemodynamics, Humans, Neck, Neck Injuries, Outcome Assessment (Health Care), Prognosis, Registries, Retrospective Studies, Survival Analysis, Thoracic Injuries, Trauma Centers, Vascular Surgical Procedures, Wounds, Nonpenetrating