@article{ref1,
title="Epidemiology of pediatric cardiac injuries: a National Trauma Data Bank analysis",
journal="Journal of pediatric surgery",
year="2011",
author="Kaptein, Yvonne E. and Talving, Peep and Konstantinidis, Agathoklis and Lam, Lydia and Inaba, Kenji and Plurad, David and Demetriades, Demetrios",
volume="46",
number="8",
pages="1564-1571",
abstract="BACKGROUND: Few studies of pediatric cardiac injuries have been conducted in large cohorts. We, therefore, investigated the epidemiology of these injuries in the United States. METHODS: We identified patients with traumatic cardiac injury from the National Trauma Data Bank, using the International Classification of Diseases, Ninth Revision, codes. Demographic data, clinical data, and in-hospital outcomes were compared among 5 age groups. A logistic regression model was used to determine adjusted mortality among these groups. RESULTS: Six hundred twenty-six patients met criteria. Fifty-nine percent sustained cardiac contusion; 36%, laceration. Penetrating injuries proved more severe than blunt, having lower average Glasgow Coma Scale (6.8 vs 8.7) and higher percentage of patients with Glasgow Coma Scale of 8 or lower (68% vs 53%). Associated injuries occurred in 484 (77%), most common being lung injuries (46%), hemopneumothorax (37%), and rib fractures (26%). Eleven percent underwent laparotomy; 9%, thoracotomy; 2%, craniotomy/craniectomy; and 0.2%, sternotomy. Complications occurred in 80 (13%), most common being cardiac arrest (4%). Firearm injuries result in the highest mortality rate (76%), compared with other mechanisms (26%-31%). Crude mortality in different age strata showed significant differences that were lost after adjustment for confounding variables. CONCLUSIONS: The predominant cardiac injury was blunt (65%; 35% sustained penetrating insults), frequently paired with contusion. Pediatric cardiac injury is associated with excessive in-hospital mortality (40%), with no age-related difference in adjusted mortality.<p /> <p>Language: en</p>",
language="en",
issn="0022-3468",
doi="10.1016/j.jpedsurg.2011.02.041",
url="http://dx.doi.org/10.1016/j.jpedsurg.2011.02.041"
}