title: Pediatric penetrating thoracic trauma: a five-year experience.
abstract: Penetrating thoracic trauma is managed nonoperatively in 85% of adult patients. We hypothesized that similar trauma in children would lead to proportionately more vital tissue damage and a higher rate of operative intervention. The pediatric penetrating thoracic trauma experience of a level one trauma center was analyzed over a five-year period. Data reviewed included circumstances of injury, Pediatric Trauma Score (PTS), interventions performed, and outcome. Of 61 children with thoracic trauma, 13 had penetrating injuries. Of these 13, seven were unintentional (five from firearms); the rest were caused by assaults. Seven patients (54%) underwent thoracotomy or laparotomy. All five patients with a PTS < 8 underwent surgical intervention, whereas only two of the eight patients with a PTS > or = 8 needed surgery (P < 0.05). There was one death. We reached the following conclusions: 1) Children with penetrating thoracic trauma are more likely to require surgical intervention than adults. 2) Penetrating thoracic trauma in children should elicit a thorough search for operative lesions. 3) About half these injuries are unintentional, and thus potentially preventable.
authors.affiliation: Department of Surgery, University of Florida Health Science Center, Jacksonville 32209.
authors.forename: R J
authors.initials: RJ
authors.lastname: Peterson
authors.forename: A D
authors.initials: AD
authors.lastname: Tiwary
authors.forename: N
authors.initials: N
authors.lastname: Kissoon
authors.forename: J J
authors.initials: JJ
authors.lastname: Tepas
authors.forename: E L
authors.initials: EL
authors.lastname: Ceithaml
authors.forename: P
authors.initials: P
authors.lastname: Pieper
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D005431:Florida; D006801:Humans; D008297:Male; D013898:Thoracic Injuries / Q000145:classification / Q000209:etiology / Q000601:surgery; D013908:Thoracotomy; D014193:Trauma Centers / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000145:classification / Q000209:etiology / Q000601:surgery