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Mechanism and mortality of pediatric aortic injuries

Jun Tashiro1, William M Hannay1, Charlene Naves1

  • 1Division of Pediatric Surgery, University of Miami, Miami, Florida.

The Journal of Surgical Research
|April 29, 2015
PubMed

Insights

Pediatric aortic injuries, often from motor vehicle accidents, have a 65% survival rate. Factors like gender, race, insurance, income, and hospital type significantly impact survival outcomes in children and adolescents.

Area of Science:

  • Pediatric Trauma Surgery
  • Vascular Injury Research
  • Public Health Surveillance

Background:

  • Aortic injuries in children and adolescents are rare but carry a high mortality rate.
  • Understanding injury mechanisms and survival predictors is crucial for this vulnerable population.

Purpose of the Study:

  • To investigate the primary mechanisms of aortic injury in pediatric patients.
  • To identify key predictors of in-hospital mortality for thoracic and abdominal aortic injuries in individuals under 20 years old.

Main Methods:

  • Utilized the Kids' Inpatient Database (1997-2009) to identify pediatric cases of aortic injury.
  • Employed bivariate and risk-adjusted multivariate analyses to assess associated diagnoses, procedures, and mortality predictors.
  • Included only emergent or urgent admissions for analysis.

Main Results:

  • Identified 468 cases with an overall survival rate of 65%. Motor vehicle accidents were the leading cause (77%).
  • Multivariate analysis revealed lower mortality in boys, Hispanic children, those in higher income quartiles, and patients at urban non-teaching hospitals.
  • Traumatic shock and exploratory laparotomy were associated with the highest mortality; survival improved from 1997 to 2009.

Conclusions:

  • Motor vehicle incidents are the predominant cause of pediatric aortic injuries.
  • Gender, race, payer status, income, and hospital type are significant determinants of mortality.
  • Associated diagnoses and procedures critically influence survival outcomes in pediatric aortic injury cases.
Abstract

Keywords:
AortaOutcomes researchVascular system injuries

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