Is pediatric trauma still a surgical disease? Patterns of emergent operative intervention in the injured child

Stephanie P. Acierno, Gregory Jurkovich, Avery B. Nathens, Mary E. Fallat, Joseph J. Tepas, Steven Ross, Barbara Gaines, David Blake, Lawrence P. Sue

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Background: Nonoperative management of many pediatric injuries has generated debate as to whether surgeons must be routinely involved in the early assessment and management of pediatric trauma. This study examines the frequency of operative intervention among injured children and evaluates potential predictors of emergent intervention. Methods: Pediatric (age < 18 years) patients were identified from the National Trauma Data Bank. Primary outcome measures were surgical intervention by specialty, time to intervention, and mortality. Prehospital factors were evaluated as predictors of emergent surgical intervention. Results: Thirty percent of trauma admissions underwent operative intervention, with 57% of these requiring emergent surgery. Patients needing emergent general or neurosurgical intervention were at increased risk of death. Requiring one type of emergent surgical intervention was predictive of needing a second type of emergent procedure. Predictors of emergent general surgical intervention were penetrating mechanism, increasing age, and the presence of shock or coma. Conclusion: These data support the continued routine involvement of surgeons in the initial assessment and management of the injured child.

Original languageEnglish (US)
Pages (from-to)960-966
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume56
Issue number5
DOIs
StatePublished - Jan 1 2004
Externally publishedYes

Keywords

  • Emergent
  • Pediatric trauma
  • Surgical intervention

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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