Analysis of pediatric sternal fractures using the Kid's Inpatient Database (KID)

Area of Science:

• Pediatric Trauma Surgery
• Injury Epidemiology
• Critical Care Medicine

Background:

• Sternal fractures are uncommon in pediatric blunt trauma.
• Understanding their association with patient outcomes is crucial for trauma management.

Purpose of the Study:

• To determine if sternal fracture predicts discharge requiring additional care and mortality in pediatric blunt trauma patients.
• To identify factors associated with adverse outcomes in this population.

Main Methods:

• Analysis of pediatric blunt trauma admissions (<18 years) from the 2016 Kid's Inpatient Database.
• Calculation of weighted incidence of sternal fracture using survey data.
• Regression analysis to identify predictors of poor outcomes.

Main Results:

• Annual incidence of pediatric sternal fracture was 0.43 per 100,000.
• Sternal fracture patients were older, more likely to have motor vehicle accidents, and sustained associated injuries (e.g., clavicle, abdominal, spinal, lung, rib fractures).
• Despite higher rates of discharge to care (22% vs 5%) and mortality (3.8% vs 0.9%), sternal fracture was not an independent predictor of these outcomes after adjustment.

Conclusions:

• Sternal fracture in pediatric blunt trauma is a marker of severe injury.
• It is not an independent predictor of mortality or the need for a higher level of care post-discharge.
• Focus should remain on managing associated injuries and overall patient condition.