Penetrating neck trauma in children: An uncommon entity described using the National Trauma Data Bank

Melvin Eugene Stone, Benjamin A. Farber, Odunayo Olorunfemi, Stanley Kalata, James A. Meltzer, Edward Chao, Srinivas H. Reddy, Sheldon Teperman

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)604-609
Number of pages6
JournalJournal of Trauma and Acute Care Surgery
Volume80
Issue number4
DOIs
StatePublished - 2016

Keywords

  • Pediatric neck trauma
  • Penetrating neck

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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