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Risk factors and outcomes in pediatric blunt cardiac injuries
Brent Emigh1,2, Areg Grigorian3, Joshua Dilday4
1Division of Trauma and Critical Care, Department of Surgery, Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA. Brent_Emigh@Brown.edu.
Pediatric Surgery International
|May 9, 2023
Summary
Pediatric blunt cardiac injury (BCI) is rare but deadly. Pulmonary contusions and hemothorax are key indicators for BCI screening in children after trauma.
Area of Science:
- Pediatric trauma care
- Cardiovascular injury research
- Emergency medicine
Background:
- Blunt cardiac injury (BCI) is poorly understood in children compared to adults.
- Identifying pediatric BCI risk factors can improve trauma screening.
Purpose of the Study:
- To identify risk factors and predictors for blunt cardiac injury (BCI) in pediatric patients.
- To inform targeted screening protocols for children sustaining blunt trauma.
Main Methods:
- Retrospective analysis of the Trauma Quality Improvement Program (TQIP) database (2017-2019).
- Inclusion of pediatric patients (≤16 years) with blunt trauma.
- Regression analysis to determine independent risk factors for BCI.
Main Results:
- BCI incidence was <0.2% in 266,045 pediatric trauma patients.
- All-cause mortality for pediatric BCI was 26%.
- Pulmonary contusions (OR 15.4) and hemothorax (OR 8.9) were strongest predictors of BCI.
Conclusions:
- Pulmonary contusions and hemothorax in pediatric trauma patients warrant further investigation for BCI.
- These findings support enhanced screening for BCI in children presenting with specific thoracic injuries.
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