Outcomes of truncal vascular injuries in children.
BACKGROUND
Pediatric truncal vascular injuries occur infrequently and have a reported mortality rate of 30% to 50%. This report examines the demographics, mechanisms of injury, associated trauma, and outcome of patients presenting for the past 10 years at a single institution with truncal vascular injuries.


METHODS
A retrospective review (1997-2006) of a pediatric trauma registry at a single institution was undertaken.


RESULTS
Seventy-five truncal vascular injuries occurred in 57 patients (age, 12 +/- 3 years); the injury mechanisms were penetrating in 37%. Concomitant injuries occurred with 76%, 62%, and 43% of abdominal, thoracic, and neck vascular injuries, respectively. Nonvascular complications occurred more frequently in patients with abdominal vascular injuries who were hemodynamically unstable on presentation. All patients with thoracic vascular injuries presenting with hemodynamic instability died. In patients with neck vascular injuries, 1 of 2 patients who were hemodynamically unstable died, compared to 1 of 12 patients who died in those who presented hemodynamically stable. Overall survival was 75%.


CONCLUSIONS
Survival and complications of pediatric truncal vascular injury are related to hemodynamic status at the time of presentation. Associated injuries are higher with trauma involving the abdomen.
Department of Pediatric Surgery and Surgery, University of Texas Medical School at Houston, Children's Memorial Hermann Hospital, Houston, TX 77030, USA.
Nathan D
ND
Allison
Christopher M
CM
Anderson
Shinil K
SK
Shah
Kevin P
KP
Lally
Andrea
A
Hayes-Jordan
Kuo-Jen
KJ
Tsao
Richard J
RJ
Andrassy
Charles S
CS
Cox
D000007:Abdominal Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D000293:Adolescent; D000714:Anastomosis, Surgical / Q000379:methods; D001808:Blood Vessels / Q000293:injuries*; D002423:Cause of Death; D002648:Child; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D009333:Neck / Q000098:blood supply; D019838:Neck Injuries / Q000175:diagnosis / Q000401:mortality; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D013898:Thoracic Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D014193:Trauma Centers / Q000706:statistics & numerical data; D014656:Vascular Surgical Procedures / Q000379:methods; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000401:mortality / Q000601:surgery