Risk factors for blunt thoracic aortic injury in children.
OBJECTIVE
Because blunt thoracic aortic injury is rare in children, a high index of suspicion is needed to identify this injury. The purpose of this study was to use a large national trauma database to define the risk factors for blunt thoracic aortic injury in children.


METHODS
Using the National Trauma Database, the authors compared patient demographics, mechanism of injury, and associated injuries between children sustaining blunt trauma with and without a thoracic aortic injury. Factors independently associated with this injury were identified using multivariate methods.


RESULTS
Among 26,940 children with a blunt mechanism of injury, 34 (0.1%) children sustained a thoracic aortic injury, 14 (41%) of whom died. Thoracic aortic injuries were independently associated with age, injury sustained as an occupant in a motor vehicle crash, and severe injuries (Abbreviated Injury Scale value of > or =3) involving the head, thorax (other than aorta), abdomen, and lower extremities.


CONCLUSIONS
Older children involved in a motor vehicle crash with severe head, torso, and lower extremity injuries are a group at high risk for injury to the thoracic aorta. These easily identifiable risk factors may facilitate more rapid identification of this rare and potentially fatal injury.
Heckman
Seth R
SR
Division of Pediatric Surgery, Department of Surgery, Robert Wood Johnson Medical School, PO Box 19, New Brunswick, NJ 08903, USA.
Trooskin
Stanley Z
SZ
Burd
Randall S
RS
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000367:Age Factors; D001013:Aorta, Thoracic / Q000293:injuries*; D002648:Child; D019992:Databases as Topic; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014656:Vascular Surgical Procedures; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery