TY - JOUR
T1 - Penetrating neck trauma in children
T2 - An uncommon entity described using the National Trauma Data Bank
AU - Stone, Melvin Eugene
AU - Farber, Benjamin A.
AU - Olorunfemi, Odunayo
AU - Kalata, Stanley
AU - Meltzer, James A.
AU - Chao, Edward
AU - Reddy, Srinivas H.
AU - Teperman, Sheldon
N1 - Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2016
Y1 - 2016
N2 - Background: Penetrating neck trauma is uncommon in children; consequently, data describing epidemiology, injury pattern, and management are sparse. The aim of this studywas to use theNational TraumaData Bank (NTDB) to describe pediatric penetrating neck trauma (PPNT). METHODS: The NTDB was queried for children (defined as <15 years old) with PPNT between years 2008 and 2012. Descriptive analysiswas used to describe age groups (0-5, 6-10, and 11-14 years) and injury type categorized as aerodigestive, vascular, cervical spine, and nerve. RESULTS: A total of 1,238 patients with penetrating neck trauma were identified among 434,788 children in the NTDB (0.28%). Mean age was 7.9 years, and 70.6% of patients were male. The most common mechanisms of injury were stabbing (44%) and gunshot/firearm(24%).Most patientswere treated at a pediatric trauma center (65.8%). Computed tomographic scanwas themost frequent (42.2%) diagnostic study performed, followed by laryngoscopy (27.0%) and esophagoscopy (27.4%). Almost a quarter of patients (23.7%) went directly to the operating room from the emergency department (ED). Aerodigestive injuries were most common and occurred more frequently in the youngest age group (p < 0.001). Operative procedures for aerodigestive type injuries were most common (82.7%). Therewere 69 deaths, yielding amortality rate of 5.6%.When adjusting for age, admission to a pediatric trauma center, and injury type, only vascular injury (odds ratio, 3.92; 95% confidence interval, 2.19-7.24; p < 0.0001) and ED hypotension (odds ratio, 27.12; 95% confidence interval, 15.11-48.67; p < 0.0001) were found to be independently associated with death. CONCLUSION: PPNT is extremely rare-0.28%reported NTDB incidence. Age seems to influence injury type but does not affectmortality. Computed tomographic scan is the dominant diagnostic study used for selective management. Vascular injury type and hypotension on presentation to the EDwere independently associated with mortality.
AB - Background: Penetrating neck trauma is uncommon in children; consequently, data describing epidemiology, injury pattern, and management are sparse. The aim of this studywas to use theNational TraumaData Bank (NTDB) to describe pediatric penetrating neck trauma (PPNT). METHODS: The NTDB was queried for children (defined as <15 years old) with PPNT between years 2008 and 2012. Descriptive analysiswas used to describe age groups (0-5, 6-10, and 11-14 years) and injury type categorized as aerodigestive, vascular, cervical spine, and nerve. RESULTS: A total of 1,238 patients with penetrating neck trauma were identified among 434,788 children in the NTDB (0.28%). Mean age was 7.9 years, and 70.6% of patients were male. The most common mechanisms of injury were stabbing (44%) and gunshot/firearm(24%).Most patientswere treated at a pediatric trauma center (65.8%). Computed tomographic scanwas themost frequent (42.2%) diagnostic study performed, followed by laryngoscopy (27.0%) and esophagoscopy (27.4%). Almost a quarter of patients (23.7%) went directly to the operating room from the emergency department (ED). Aerodigestive injuries were most common and occurred more frequently in the youngest age group (p < 0.001). Operative procedures for aerodigestive type injuries were most common (82.7%). Therewere 69 deaths, yielding amortality rate of 5.6%.When adjusting for age, admission to a pediatric trauma center, and injury type, only vascular injury (odds ratio, 3.92; 95% confidence interval, 2.19-7.24; p < 0.0001) and ED hypotension (odds ratio, 27.12; 95% confidence interval, 15.11-48.67; p < 0.0001) were found to be independently associated with death. CONCLUSION: PPNT is extremely rare-0.28%reported NTDB incidence. Age seems to influence injury type but does not affectmortality. Computed tomographic scan is the dominant diagnostic study used for selective management. Vascular injury type and hypotension on presentation to the EDwere independently associated with mortality.
KW - Pediatric neck trauma
KW - Penetrating neck
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U2 - 10.1097/TA.0000000000000976
DO - 10.1097/TA.0000000000000976
M3 - Article
C2 - 26808024
AN - SCOPUS:84955604505
SN - 2163-0755
VL - 80
SP - 604
EP - 609
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
IS - 4
ER -