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Pediatric Trauma

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149 papers 100 to 500 followers
Maria E Linnaus, David M Notrica, Crystal S Langlais, Shawn D St Peter, Charles M Leys, Daniel J Ostlie, R Todd Maxson, Todd Ponsky, David W Tuggle, James W Eubanks, Amina Bhatia, Adam C Alder, Cynthia Greenwell, Nilda M Garcia, Karla A Lawson, Prasenjeet Motghare, Robert W Letton
BACKGROUND: Age-adjusted pediatric shock index (SIPA) does not require knowledge of age-adjusted blood pressure norms, yet correlates with mortality, serious injury, and need for transfusion in trauma. No prospective studies support its validity. METHODS: A multicenter prospective observational study of patients 4-16years presenting April 2013-January 2016 with blunt liver and/or spleen injury (BLSI). SIPA (maximum heart rate/minimum systolic blood pressure) thresholds of >1...
September 23, 2016: Journal of Pediatric Surgery
Katherine W Gonzalez, Brian G Dalton, Michael C Kerisey, Pablo Aguayo, David Juang
Introduction Pelvic angiography with embolization can successfully control hemorrhage in adults with pelvic fractures. However, evidence to support similar application in children is sparse. We describe our experience using angiography for pediatric pelvic fractures to further highlight the safety and efficacy of this treatment approach. Methods A retrospective review at a pediatric tertiary care center was performed from 2004 to 2014. Inpatients treated for a pelvic fracture were considered. Results A total of 216 patients were analyzed...
July 1, 2016: European Journal of Pediatric Surgery
Mary Kirkilas, David M Notrica, Crystal S Langlais, Jared T Muenzer, Jozef Zoldos, Kathleen Graziano
BACKGROUND: Vascular trauma in children, although rare, carries significant risk for repair. Here we report outcomes from a single trauma center for children with extremity vascular trauma, proximal to the digits. METHODS: Retrospective chart review of patients less than age 18years with an acute, non-iatrogenic traumatic arterial vascular injury of the upper and/or lower extremity between January 2008 and December 2013. Abstracted patient demographics, injury characteristics, surgical management, and disposition were summarized and compared with nonparametric methods...
November 2016: Journal of Pediatric Surgery
Mary C Pierce, Julia N Magana, Kim Kaczor, Douglas J Lorenz, Gabriel Meyers, Berkeley L Bennett, John T Kanegaye
STUDY OBJECTIVE: Bruising can indicate abuse for infants. Bruise prevalence among infants in the pediatric emergency department (ED) setting is unknown. Our objective is to determine prevalence of bruising, associated chief complaints, and frequency of abuse evaluations in previously healthy infants presenting to pediatric EDs. METHODS: We conducted a prospective, observational, multicenter study of infants aged 12 months or younger presenting to pediatric EDs. Structured sampling was used...
January 2016: Annals of Emergency Medicine
Matthew A Eisenberg, John Andrea, William Meehan, Rebekah Mannix
OBJECTIVE: To test the hypothesis that children with a previous history of concussion have a longer duration of symptoms after a repeat concussion than those without such a history. METHODS: Prospective cohort study of consecutive patients 11 to 22 years old presenting to the emergency department of a children's hospital with an acute concussion. The main outcome measure was time to symptom resolution, assessed by the Rivermead Post-Concussion Symptoms Questionnaire (RPSQ)...
July 2013: Pediatrics
Matthew A Eisenberg, William P Meehan, Rebekah Mannix
OBJECTIVES: To examine the incidence, duration, and clinical course of individual post-concussive symptoms in patients presenting to a pediatric emergency department (ED) with a concussion. METHODS: We conducted secondary analysis of a prospective cohort study of patients 11 to 22 years old presenting to the ED of a children's hospital with an acute concussion. The main outcome measure was duration of symptoms, assessed by the Rivermead Post-Concussion Symptoms Questionnaire (RPSQ)...
June 2014: Pediatrics
Kate Dorney, Amir Kimia, Megan Hannon, Kara Hennelly, William P Meehan, Mark Proctor, David P Mooney, Michael Glotzbecker, Rebekah Mannix
BACKGROUND: There is little evidence to guide management of pediatric patients with persistent cervical spine tenderness after trauma but with negative initial imaging study findings. Our objective was to determine the prevalence of clinically significant cervical spine injury among pediatric blunt trauma patients discharged from the emergency department with negative imaging study findings but persistent midline cervical spine tenderness. METHODS: We performed a single-center, retrospective study of subjects 1 year to 15 years of age discharged in a rigid cervical spine collar after blunt trauma over a 5-year period...
November 2015: Journal of Trauma and Acute Care Surgery
Sohail R Shah, Peter D Wearden, Barbara A Gaines
BACKGROUND: This study evaluated peripheral vascular injuries in a pediatric trauma population to identify injury patterns, to identify diagnostic and therapeutic modalities used, and to understand the role of pediatric surgical subspecialists. METHODS: A retrospective review of children treated for trauma between 2000 and 2006 at a Level I Pediatric Trauma Center was performed. Patients with vascular injury were identified through an institutional trauma registry...
May 1, 2009: Journal of Surgical Research
Denise B Klinkner, Marjorie J Arca, Brian D Lewis, Keith T Oldham, Thomas T Sato
PURPOSE: The purpose of this study was to identify the patterns of injury and associated morbidity/mortality related to pediatric vascular trauma. METHODS: A retrospective review of children and adolescents treated between 1993 and 2005 was performed. Patients were identified by International Classification of Diseases, Ninth Revision codes within an institutional pediatric trauma registry. RESULTS: One hundred seventy-six patients with vascular injury were identified...
January 2007: Journal of Pediatric Surgery
Michael G Corneille, Theresa M Gallup, Celina Villa, Jacqueline M Richa, Steven E Wolf, John G Myers, Daniel L Dent, Ronald M Stewart
BACKGROUND: Although uncommon in children, traumatic vascular injuries have the potential for lifelong disability. We reviewed these injuries, their acute management, and early outcomes at a Level I trauma center. METHODS: Retrospective review of patients identified through trauma registry was query of all noniatrogenic vascular injuries in a pediatric population during a 13-year period. Demographics, injury type and management, concomitant injuries, and inpatient outcomes were analyzed...
April 2011: Journal of Trauma
Galinos Barmparas, Kenji Inaba, Peep Talving, Jean-Stephane David, Lydia Lam, David Plurad, Donald Green, Demetrios Demetriades
INTRODUCTION: The purpose of this study was to examine nationwide data on vascular injuries in children and to compare pediatric and adult patients with respect to the incidence, injury mechanisms, and outcomes. METHODS: This is a National Trauma Databank analysis based on dataset version 7.0 (spanning a 5-year period ending December 2006). Pediatric patients under the age of 16 with at least one reported diagnosis of a vascular injury were compared to the adult cohort aged 16 and greater with a vascular injury...
July 2010: Journal of Pediatric Surgery
Nima Azarakhsh, Sandra Grimes, David M Notrica, Alexander Raines, Nilda M Garcia, David W Tuggle, Robert Todd Maxson, Adam C Alder, John Recicar, Pamela Garcia-Filion, Cynthia Greenwell, Karla A Lawson, Jim Y Wan, James Wallace Eubanks
BACKGROUND: Blunt cerebrovascular injury (BCVI) has been well described in the adult trauma literature. The risk factors, proper screening, and treatment options are well known. In pediatric trauma, there has been very little research performed regarding this injury. We hypothesize that the incidence of BCVI in children is lower than the 1% reported incidence in adult studies and that many children at risk are not being screened properly. METHODS: This is a multi-institutional retrospective cohort study of pediatric patients (<15 years) admitted with blunt trauma to six American College of Surgeons-verified Level 1 pediatric trauma centers between October 2009 and June 2011...
December 2013: Journal of Trauma and Acute Care Surgery
Vijay M Ravindra, Jay Riva-Cambrin, Walavan Sivakumar, Ryan R Metzger, Robert J Bollo
OBJECT Computed tomography angiography (CTA) is frequently used to examine patients for blunt cerebrovascular injury (BCVI) after cranial trauma, but the pediatric population at risk for BCVI is poorly defined. Although CTA is effective for BCVI screening in adults, the increased lifetime risk for malignant tumors associated with this screening modality warrants efforts to reduce its use in children. The authors' objective was to evaluate the incidence of BCVI diagnosed by CTA in a pediatric patient cohort and to create a prediction model to identify children at high risk for BCVI...
June 2015: Journal of Neurosurgery. Pediatrics
Tammy R Kopelman, Nicole E Berardoni, Patrick J O'Neill, Poya Hedayati, Sydney J Vail, Paola G Pieri, Iman Feiz-Erfan, Melissa A Pressman
BACKGROUND: Eastern Association for the Surgery of Trauma guideline for the evaluation of blunt cerebrovascular injury (BCVI) states that pediatric trauma patients should be evaluated using the same criteria as the adult population. The purpose of our study was to determine whether adult criteria translate to the pediatric population. METHODS: Retrospective evaluation was performed at a Level I trauma center of blunt pediatric trauma patients (age <15 years) presenting over a 5-year period...
September 2011: Journal of Trauma
Ajay Malhotra, Xiao Wu, Vivek B Kalra, Thomas R Goodman, Joseph Schindler, Howard P Forman
BACKGROUND: Timely and accurate screening for pediatric blunt cerebrovascular injury (BCVI) is important in order to administer appropriate anticoagulation therapy thus preventing stroke. The recommended criteria for screening in children are not clear. We performed a systematic review of the literature for screening and management of BCVI in children and designed a cost-effectiveness analysis in order to determine the optimal strategy for managing pediatric BCVI from a societal perspective...
October 2015: Journal of Pediatric Surgery
Vijay M Ravindra, Robert Bollo, Walavan Sivakumar, Hassan Akbari, Robert P Naftel, David D Limbrick, Andrew Jea, Stephen R Gannon, Chevis Shannon, Yekaterina Birkas, George L Yang, Colin T Prather, John Kestle, Jay Riva-Cambrin
Risk factors for blunt cerebrovascular injury (BCVI) may differ between children and adults, suggesting that children at low risk for BCVI after trauma receive unnecessary computed tomography angiography (CTA) and high-dose radiation. We previously developed a score for predicting pediatric BCVI based on retrospective cohort analysis. Our objective is to externally validate this prediction score with a retrospective multi-institutional cohort. We included patients who underwent CTA for traumatic cranial injury at four pediatric level-one trauma centers...
June 13, 2016: Journal of Neurotrauma
Derek J Roberts, Chad G Ball, David V Feliciano, Ernest E Moore, Rao R Ivatury, Charles E Lucas, Timothy C Fabian, David A Zygun, Andrew W Kirkpatrick, Henry T Stelfox
OBJECTIVE: To review the history of the innovation of damage control (DC) for management of trauma patients. BACKGROUND: DC is an important development in trauma care that provides a valuable case study in surgical innovation. METHODS: We searched bibliographic databases (1950-2015), conference abstracts (2009-2013), Web sites, textbooks, and bibliographies for articles relating to trauma DC. The innovation of DC was then classified according to the Innovation, Development, Exploration, Assessment, and Long-term study model of surgical innovation...
June 17, 2016: Annals of Surgery
Sheila J Hanson, E Vincent S Faustino, Arash Mahajerin, Sarah H O'Brien, Christian J Streck, A Jill Thompson, Toni M Petrillo, John K Petty
No abstract text is available yet for this article.
May 2016: Journal of Trauma and Acute Care Surgery
Jill Dreyfus, Andrew Flood, Gretchen Cutler, Henry Ortega, Nathan Kreykes, Anupam Kharbanda
OBJECTIVE: Examine the association of American College of Surgeons Level I pediatric trauma center designation with outcomes of pediatric motor vehicle collision-related injuries. METHODS: Observational study of the 2009-2012 National Trauma Data Bank, including n=28,145 patients <18years directly transported to a Level I trauma center. Generalized estimating equations estimated odds ratios (ORs) for injury outcomes, comparing freestanding pediatric trauma centers (PTCs) with adult centers having added Level I pediatric qualifications (ATC+PTC) and general adult trauma centers (ATC)...
October 2016: Journal of Pediatric Surgery
Summer Magoteaux, Megan Gilbert, Crystal S Langlais, Pamela Garcia-Filion, David M Notrica
BACKGROUND: In many hospitals, children with suspected nonaccidental trauma (sNAT) are admitted to nonsurgical services (NSS). Although the surgical service (SS) initially admitted sNAT patients at our American College of Surgeons (ACS)-verified level 1 pediatric trauma center (vPTC), a change in hospital policy allowed admission to NSS. The objective of this study was to determine if the rate of care-related indicators (CRIs) varies by admission to an SS vs an NSS in the sNAT patient population...
May 2016: Journal of the American College of Surgeons
2016-05-04 15:34:38
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