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Related Experiment Videos

Thoracic vascular injuries: a post mortem study.

K Bergman1, L Spence, D Wesson

  • 1Department of Surgery, Hospital for Sick Children, Toronto, Canada.

The Journal of Trauma
|May 1, 1990
PubMed
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Major thoracic vascular injuries are a frequent cause of death in pediatric trauma patients, often occurring rapidly before reaching a trauma center. Prevention strategies are crucial for reducing these fatalities in children.

Area of Science:

  • Pediatric Trauma Surgery
  • Thoracic Vascular Injuries
  • Forensic Pathology

Background:

  • Major thoracic vascular injuries are a significant cause of mortality in pediatric trauma.
  • Previous reports may underestimate their incidence due to rapid fatality.
  • Understanding the epidemiology is vital for improving outcomes.

Purpose of the Study:

  • To determine the incidence and characteristics of major thoracic vascular injuries in pediatric trauma fatalities.
  • To identify the most commonly injured vessels and time to death.
  • To inform prevention strategies.

Main Methods:

  • Retrospective review of coroner's records for pediatric trauma fatalities in Ontario (1985-1987).
  • Analysis of autopsy data for 322 cases, identifying major thoracic vascular injuries.

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  • Correlation with injury severity (AIS 6) and time to death.

    • Main Results:

    • Twenty-six cases (8%) had major thoracic vascular injuries among 322 pediatric trauma fatalities.
    • The aorta was the most frequently injured vessel.
    • Twenty-five deaths occurred within 6 hours of injury, with most having severe injuries (AIS 6).

    Conclusions:

    • Major thoracic vascular injuries are more common in pediatric trauma than previously thought, often due to rapid fatality.
    • Many fatalities occur outside of trauma centers, highlighting the need for immediate field/local care.
    • Focus should be on primary and secondary prevention to reduce these devastating injuries.