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Published on: November 8, 2024

Thoracic firearm injuries in children: management and analysis of prognostic factors

Sevval Eren1, Akin Eraslan Balci, Refik Ulku

  • 1Department of Thoracic and Cardiovascular Surgery, Dicle University School of Medicine, 21280, Diyarbakir, Turkey. sevval@dicle.edu.tr

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|June 28, 2003
PubMed

Insights

Pediatric thoracic firearm injuries (TFI) often require tube thoracostomy for treatment. The Injury Severity Score (ISS) effectively predicts the need for thoracotomy, and associated morbidity and mortality rates in children.

Area of Science:

  • Pediatric Trauma Surgery
  • Emergency Medicine
  • Forensic Pathology

Background:

  • Thoracic firearm injuries (TFI) are a growing concern in pediatric populations.
  • Understanding the specific injury patterns and outcomes is crucial for effective management.

Purpose of the Study:

  • To analyze the injury patterns, Injury Severity Score (ISS), length of hospital stay (LOS), management, and outcomes of pediatric TFI.
  • To evaluate the predictive value of ISS for injury severity, need for thoracotomy, morbidity, and mortality.

Main Methods:

  • A retrospective review of 110 children (
  • Children were categorized by injury type: high-velocity gunshot wounds (HVGSW), low-velocity gunshot wounds (LVGSW), shotgun wounds (SGW), and explosives wounds (EW).
  • Injury Severity Score (ISS) was calculated, and its correlation with prognostic factors was analyzed.

Main Results:

  • Lung injury was observed in 65.5% of patients; 76.3% were managed with tube thoracostomy.
  • Morbidity and mortality rates were 16.3% and 4.5%, respectively.
  • Shotgun wounds (SGW) and explosives wounds (EW) were associated with significantly higher ISS and longer LOS compared to gunshot wounds. An ISS >25 correlated with increased need for thoracotomy, morbidity, and mortality.

Conclusions:

  • Most pediatric TFI can be successfully managed with tube thoracostomy, provided there are no severe pulmonary lacerations or airway injuries.
  • The Injury Severity Score (ISS) is a reliable independent predictor for the need for thoracotomy, as well as for morbidity and mortality rates in pediatric thoracic firearm injuries.
Abstract

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