title: [Thoracic injuries in severely injured children : Association with increased injury severity and a higher number of complications].
abstract: BACKGROUND
  Severely injured children and adolescents in clinical practice are rare. For adequate treatment of these patients, detailed knowledge of anatomical and physiological peculiarities, as well as abundant injury patterns, are indispensable. Traumatic brain injuries are known to lead to an unfavorable outcome. In addition, thoracic trauma is regarded as prognostically unfavorable.
  
  
  OBJECTIVE
  This study depicts epidemiology and injury patterns of severely injured children and adolescents focusing on peculiarities in the severely injured with associated thoracic injuries.
  
  
  METHODS
  A retrospective analysis of underaged patients with suspicion of severe injuries who obtained emergency-room treatment in our level-one trauma center during a four-year time period was performed. The data was collected prospectively using the TraumaRegister® of the German Trauma Society as well as an extended house-internal dataset including data of daily clinical routine. The patients were divided into subgroups with (TT) and without (KT) thoracic trauma based on whether a thoracic injury was present or not. For further analysis, four age groups were established.
  
  
  RESULTS
  In all, 256 patients younger than 18 years were eligible. Of these, 46 patients revealed thoracic injuries. The mean age of patients with thoracic trauma (12.4 ± 4.9 years) was significantly higher than for patients without thoracic trauma (8.0 ± 5.2 years). In both subgroups, most patients were male (TT: 69.9%, KT: 64.8%). Patients with concomitant thoracic trauma showed a significantly higher injury severity score (ISS) than patients without thoracic trauma (ISS: TT: 26.7 ± 15.8 vs. KT: 8.1 ± 6.8 points). Mortality was higher for TT as well (TT: 6.9% vs. KT: 1.9%). For both groups, traffic accidents were the most common cause of injury. Of patients with thoracic injuries, 52.2% developed at least one complication during their hospital stay (KT: 12.9%).
  
  
  CONCLUSIONS
  Thoracic trauma is a relevant factor in children with regard to the severity of total injury and complications. Particular attention should therefore be paid to early diagnosis and treatment.
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland. philipp.stoermann@kgu.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Störmann
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
authors.forename: Julia Nadine
authors.initials: JN
authors.lastname: Weber
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.|Klinik für Chirurgie, Abteilung Unfall- und Wiederherstellungschirurgie, Kreiskrankenhaus St. Ingbert, Klaus-Tussing-Str. 1, St. Ingbert, 66386, Deutschland.
authors.forename: Heike
authors.initials: H
authors.lastname: Jakob
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
authors.forename: Ingo
authors.initials: I
authors.lastname: Marzi
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.|Abtl. für Unfallchirurgie, Sportorthopädie und Kindertraumatologie der BGU Murnau und des Klinikums Garmisch-Partenkirchen, Auenstr. 6, Garmisch-Partenkirchen, 82467, Deutschland.
authors.forename: Dorien
authors.initials: D
authors.lastname: Schneidmueller
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D002648:Child; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D014193:Trauma Centers / Q000706:statistics & numerical data
keywords: Complications; Multiple injury; Pediatric trauma; Thoracic trauma