Pediatric Peripheral Vascular Trauma: Incidence and Outcomes

Area of Science:

• Vascular Surgery
• Pediatric Trauma
• Trauma Registry Analysis

Background:

• Peripheral vascular trauma (PVT) is an uncommon injury in pediatric patients, with an incidence below 1%.
• Understanding risk factors for major amputation in pediatric PVT is essential for improving patient management and outcomes.

Purpose of the Study:

• To investigate the incidence of pediatric PVT.
• To identify risk factors associated with major amputation in children sustaining PVT.

Main Methods:

• Retrospective analysis of the 2019 National Trauma Data Bank (NTDB).
• Evaluation of demographics, injury characteristics, trauma center data, injury severity, length of stay, and amputation rates.
• Chi-square and t-tests were used for statistical analysis.

Main Results:

• Out of 130,554 pediatric trauma patients, 1196 (0.9%) experienced PVT, involving 1460 extremities.
• The majority of patients were male (78%) with a mean age of 14 years; penetrating injuries were most common (62.2%).
• Major amputation occurred in 2.6% of patients, with significantly higher odds for blunt trauma (OR 3.3) and lower limb PVT (OR 11.1).

Conclusions:

• Blunt mechanism and lower extremity involvement are significant predictors of major amputation in pediatric peripheral vascular trauma.
• These findings highlight the need for heightened vigilance and tailored management strategies for pediatric patients with PVT, particularly those with lower limb injuries or blunt trauma.