Patients at High Risk of Intervention for Pediatric Traumatic Liver Injury

Pediatric Emergency Care
Katie A DonnellyKaren J OʼConnell

Abstract

Nonoperative management of hemodynamically stable liver lacerations in pediatric trauma patients is a safe and effective management strategy for pediatric patients; approximately 90% will be successfully managed nonoperatively. No study has specifically identified risk criteria for the need for intervention versus observation alone. Our objective for this study was to determine risk factors from the physical examination, computed tomography scan, and laboratory results associated with intervention for liver laceration. We performed a retrospective cohort study using data from the Pediatric Emergency Care Applied Research Network Intra-abdominal Injuries Study public use data set. Data were collected prospectively at the time of enrollment; a limited data set was released for public use in 2014. Patients were included if they were diagnosed with a liver laceration by computed tomography scan. We used bivariable and multivariable analyses to determine associations of specific risk factors with intervention, defined as laparotomy, angiographic embolization, blood transfusion, death, or return to emergency department for any reason within 30 days. Of the 12,044 patients in the Intra-abdominal Injuries Study, 282 were diagnosed with...Continue Reading

References

Jun 1, 1994·Annals of Surgery·J A HallerP Colombani
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Mar 13, 2003·Journal of Pediatric Surgery·James W EubanksPhilip C Guzzetta
Jun 19, 2003·The Journal of Trauma·Demetrios DemetriadesLinda Chan
Jun 19, 2008·Journal of Pediatric Surgery·Marcene R McVaySamuel D Smith
Aug 15, 2009·The Journal of Trauma·Barbara A Gaines
Feb 5, 2013·Annals of Emergency Medicine·James F HolmesUNKNOWN Pediatric Emergency Care Applied Research Network (PECARN)
Mar 19, 2014·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Heather E FremgenDouglas C Barnhart
Sep 25, 2015·The Journal of Trauma and Acute Care Surgery·David M NotricaPamela Garcia-Filion

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