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Clinical Investigation of Pediatric Blunt Thoracic Trauma  

Chung, Tae Kyo (Department of Emergency Medicine, Gil Medical Center, Gachon Medical School)
Hyun, Sung Youl (Department of Thoracic & Cardiovascular Surgery, Gil Medical Center, Gachon Medical School)
Kim, Jin Joo (Department of Emergency Medicine, Gil Medical Center, Gachon Medical School)
Ryoo, EeIl (Department of Pediatrics, Gil Medical Center, Gachon Medical School)
Lee, Kun (Department of Emergency Medicine, Gil Medical Center, Gachon Medical School)
Cho, Jin Seung (Emergency Medical Information Center, Incheon)
Hwang, Sung Yun (Department of Emergency Medicine, Masan Samsung Hospital, Sungkyunkwan University School of Medicine)
Lee, Suk Ki (Department of Thoracic & Cardiovascular Surgery, College of Medicine, Chosun University)
Publication Information
Journal of Trauma and Injury / v.18, no.2, 2005 , pp. 119-126 More about this Journal
Abstract
Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.
Keywords
Thoracic injuries; Blunt injuries; Pediatrics;
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1 Allshouse MJ, Eichelberger MR. Patterns of thoracic injury. In: Eichelberger MR eds. Pediatric trauma, prevention, acute care, rehabilitation. St. Louis: Mosby-Year Book, 1993;437-448
2 Rielly JP, Brandt ML, Mattox KL, Pokorny WJ.Thoracic trauma in children. J Trauma 1993;34 : 329 - 333   DOI   PUBMED
3 Ceran S, Sunam GS, Aribas OK, Gormus N, Solak H.Chest trauma in children. Eur J Cardiothorac Surg 2002;21:57-59   DOI   ScienceOn
4 최마이클승필, 박정배. 소아 추락환자의 임상적 고찰. 대한 응급의학회지 2003 ; 14 : 555 - 559
5 정지윤, 백경원, 이국종, 조준필. 교통사고로 인한 중증 손상환자에 대한 분석. 대한외상학회지 2004 ; 17 : 139 - 148
6 Nakayama DK, Ramenofsky ML, Rowe MI. Chest injuries in childhood. Ann Surg 1989;210:770-775   DOI   PUBMED   ScienceOn
7 Roux P, Fisher RM. Chest injuries in children: An analysis of 100 cases of blunt chest trauma from motor vehicle accidents. J Pediatr Surg 1992;27:551- 5 5 5   DOI   ScienceOn
8 Sarihan H, Abbes M, Akyazici R, Cay A, Imamoglu M, Tasdelen I. Blunt thoracic trauma in children. J Cardiovasc Surg 1996;37:525-528
9 Clark GC, Schecter WP, Trunkey DD. Variables affecting outcome in blunt chest trauma: flail chest vs pulmonary contusion. J Trauma 1988;28:298-304   DOI   PUBMED
10 Johnson JA, Cogbill TH, Winga ER. Determinants of outcome after pulmonary contusion. J Trauma 1986 ; 26 : 695 - 697   DOI   PUBMED
11 Peterson RJ, Tepas III JJ, Edward FH, Kissoon N, Pieper P, Ceithaml EL. Pediatric and adult thoracic trauma: Age-related impact on presentation and outcome. Ann Thorac Surg 1994;58:14-18   DOI   PUBMED   ScienceOn
12 Peclet MH, Newman KD, Eichelberger MR, Gotschall CS, Garcia VF, Bowman LM. Thoracic trauma in children: An indicator of increased mortality. J Pediatr Surg 1990;25:961-965   DOI   ScienceOn
13 Balci AE, Kazez A, Eren S, Ayan E, Ozalp K, Eren MN.Blunt thoracic trauma in children: review of 137 cases. Eur J Cardiothorac Surg 2004;26:387-392   DOI   ScienceOn
14 김진주, 신종환, 진욱, 현성열, 임용수, 양혁준, 이근, 이석기. 흉부 컴퓨터 단층 촬영을 이용한 폐좌상의 중증도 측정 및 그 유용성. 대한응급의학회지 2004 ; 15 : 452 - 455
15 Black TL, Synder CL, Miller JP, Mann Jr CM, Copetas AC, Ellis DG. Significance of chest trauma in children. South Med J 1996;89:494-496   DOI   ScienceOn