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Comparative analysis of traumatic esophageal injury in pediatric and adult populations
Alexander A Xu1, Janis L Breeze2, Carl-Christian A Jackson3
1Tufts University School of Medicine, Boston, MA, USA.
Insights
Pediatric traumatic injury of the esophagus (TIE) is more common from blunt trauma and has better outcomes than in adults. This study compared TIE in children and adults, finding unique characteristics in the pediatric population.
Area of Science:
- Trauma Surgery
- Pediatric Surgery
- Esophageal Injuries
Background:
- Traumatic injury of the esophagus (TIE) is rare, and its distribution and outcomes in pediatric versus adult populations are not well understood.
- Understanding these differences is crucial for optimizing treatment and improving patient outcomes.
Purpose of the Study:
- To describe and compare the demographics, injury characteristics, and clinical outcomes of pediatric and adult patients with traumatic injury of the esophagus.
- To identify unique features of TIE in pediatric populations.
Main Methods:
- A retrospective analysis of the National Trauma Data Bank (NTDB) from 2010 to 2015.
- Identification and comparison of pediatric (age < 16 years) and adult TIE patients based on demographics, injury severity, associated injuries, complications, and outcomes.
Main Results:
- Among trauma patients, 0.02% of pediatric and 0.04% of adult cases involved TIE.
- Pediatric TIE was more frequently blunt trauma (63% vs. 37%), associated with lower injury severity (ISS 14 vs. 22), fewer complications (30% vs. 51%), shorter hospitalizations (5 vs. 10 days), and higher discharge home rates (84% vs. 64%).
- In-hospital mortality did not significantly differ between pediatric and adult TIE patients (10% vs. 19%).
Conclusions:
- Traumatic injury of the esophagus in children presents with distinct characteristics compared to adults.
- Pediatric TIE is more often caused by blunt mechanisms, involves a lower overall injury burden, and is associated with more favorable clinical outcomes.
- Despite differences in injury patterns and severity, in-hospital mortality rates were comparable between pediatric and adult TIE patients.
Purpose:
Distribution and outcomes of traumatic injury of the esophagus (TIE) in pediatric versus adult populations are unknown. Our study sought to perform a descriptive analysis of TIE in children and adults.
Methods:
We reviewed the National Trauma Data Bank (NTDB) for the years 2010-2015. Demographics, characteristics, and outcomes of pediatric (age < 16 years) and adult TIE patients were described and compared.
Results:
Among 526,850 pediatric and 3,838,895 adult trauma patients, 90 pediatric (0.02%) and 1,411 (0.04%) adult TIE patients were identified. Demographics and esophageal injury severity did not differ. Children were more likely to sustain blunt trauma (63% versus 37%), with the most common mechanism being transportation-related accidents, were less-severely injured (median ISS 14 versus 22), and had fewer associated injuries (79% versus 95%) and complications (30% versus 51%) (all p < 0.001). Children had shorter hospitalizations (median 5 versus 10 days) and were more likely to be discharged home (84% versus 64%) (both p = 0.01). In-hospital mortality did not differ significantly between children and adults (10% versus 19%, p = 0.09).
Conclusion:
TIE in the pediatric population has unique characteristics compared to adults: it is more likely to be a result of blunt trauma, has lower injury burden, and has more favorable clinical outcomes.
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