Pediatric penetrating thoracic trauma: a five-year experience

Area of Science:

• Trauma Surgery
• Pediatric Surgery
• Thoracic Trauma Management

Background:

• Adults with penetrating thoracic trauma are nonoperatively managed in 85% of cases.
• Pediatric penetrating thoracic trauma may cause more vital tissue damage and necessitate operative intervention.
• A level one trauma center's experience with pediatric penetrating thoracic trauma was analyzed.

Purpose of the Study:

• To investigate the hypothesis that pediatric penetrating thoracic trauma leads to proportionately more vital tissue damage and a higher rate of operative intervention compared to adults.
• To analyze the circumstances, interventions, and outcomes of pediatric penetrating thoracic trauma.
• To determine the likelihood of surgical intervention in children with penetrating thoracic trauma.

Main Methods:

• Retrospective analysis of pediatric penetrating thoracic trauma cases over a five-year period.
• Data reviewed included injury circumstances, Pediatric Trauma Score (PTS), interventions, and outcomes.
• Comparison of surgical intervention rates based on PTS.

Main Results:

• Out of 61 children with thoracic trauma, 13 sustained penetrating injuries.
• Seven patients (54%) underwent thoracotomy or laparotomy.
• All five patients with a PTS < 8 required surgery, versus two of eight patients with a PTS > or = 8 (P < 0.05).

Conclusions:

• Children with penetrating thoracic trauma are more likely to require surgical intervention than adults.
• Penetrating thoracic trauma in children warrants a thorough search for operative lesions.
• Approximately half of these pediatric thoracic trauma injuries are unintentional and potentially preventable.