@article{ref1,
title="Pediatric vascular injury: experience of a Level 1 trauma center",
journal="Journal of surgical research",
year="2015",
author="Allen, Casey J. and Straker, Richard J. and Tashiro, Jun and Teisch, Laura F. and Meizoso, Jonathan P. and Ray, Juliet J. and Namias, Nicholas and Sola, Juan E.",
volume="196",
number="1",
pages="1-7",
abstract="BACKGROUND: Our purpose was to analyze modern major vascular injury (MVI) patterns in pediatric trauma, interventions performed, and outcomes at a level 1 trauma center. <br><br>MATERIALS AND METHODS: From January 2000-December 2012, all pediatric admissions (<= 17 y) were reviewed. <br><br>RESULTS: Of 1928 pediatric admissions, 103 (5.3%) sustained MVI. This cohort was 85% male, age 15 +/- 3 y, 55% black, 58% penetrating, injury severity score of 23 +/- 15, with a length of stay of 8 (5) days. Firearm-related injury (47%) was the most common mechanism. Location of injuries included the extremities (50.5%), abdomen/pelvis (29.1%), and chest/neck (20.4%). Operative procedures included repair/bypass (71.4%), ligation (12.4%), amputation (10.5%), or temporary shunt (2.9%). Only three injuries (2.9%) were treated endovascularly. MVI patients had a mortality rate of 19.4%, higher than the overall pediatric trauma population of 3.5% (P < 0.001). After logistic regression, independent risk factors of mortality were vascular injury to the neck (odds ratio [OR]: 6.5; confidence interval (CI): 1.1-39.3), abdomen/pelvis (OR: 16.3; CI: 3.13-80.2), and chest (OR: 49.0; CI: 3.0-794.5). <br><br>CONCLUSIONS: MVI in children more commonly results from firearm-related injury. The mortality rate associated with MVI is profoundly higher than that of the overall pediatric trauma population. These findings underscore the major public health concern of firearm-related injury in children. (C) 2015 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0022-4804",
doi="10.1016/j.jss.2015.02.023",
url="http://dx.doi.org/10.1016/j.jss.2015.02.023"
}