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. 2021 Jun;52(6):1316-1320.
doi: 10.1016/j.injury.2021.02.033. Epub 2021 Feb 17.

Thoracic Injuries in Pediatric Polytraumatized Patients: Epidemiology, Treatment and Outcome

R C Ostermann  1 , J Joestl  2 , N Lang  2 , Thomas M Tiefenboeck  2 , Sylvina Ohnesorg  2 , P Platzer  2 , M Hofbauer  2
Affiliations

Thoracic Injuries in Pediatric Polytraumatized Patients: Epidemiology, Treatment and Outcome

R C Ostermann et al. Injury. 2021 Jun.

Abstract

Purpose: The purpose of the present study was to assess the influence and contribution, epidemiology, treatment and outcome of thoracic injuries in a cohort of pediatric and adolescent polytraumatized patients.

Material and methods: All pediatric and adolescent (age < 18 years) polytraumatized patients with associated thoracic injuries were included in this study. Demographic data, mechanism of injury (MOI), injury severity score (ISS), Glasgow Coma Scale (GCS), hemodynamic parameters and pupillary response at ED admission, site of major injury (SOMI), associated chest and non-chest related injuries, length of hospital stay (LOS), procedures performed at the ED as well as outcome variables including mortality and cause of death. Stepwise logistic regression analysis was used to identify risk factors for a poor prognosis and outcome.

Results: The logistic regression found the following variables decreasing the odds for a "bad outcome": lack of a hemodynamically unstable condition (p = 0.009) and the absence of a pathological pupillary response (p < 0.001).

Conclusions: The present study suggests that the severity of concomitant chest injuries in polytraumatized pediatric and adolescent patients contributes substantially to morbidity and mortality. Due to the anatomic features of the immature pediatric bones, careful attention should be drawn to possible severe chest injuries even in the absence of rib fractures.

Level of evidence: A retrospective study (level - IV study).

Keywords: Chest injuries; Outcome prediction; Pediatric patients; Polytrauma.

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Conflict of interest statement

Declaration of Competing Interest The authors whose names are listed immediately below certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.