Conservative approach to the treatment of injured liver and spleen in children: association with reduced mortality.
Pediatr Surg Int
; 25(7): 583-6, 2009 Jul.
Article
em En
| MEDLINE
| ID: mdl-19517122
ABSTRACT
BACKGROUND:
Previous analyses of the safety of the conservative versus the operative approach to the treatment of liver and spleen blunt injuries in children often failed to account for differences in quality of care and expertise among dedicated pediatric trauma center, non-pediatric centers, centers without trauma units, and non-trauma centers. To eliminate this potential bias, the present study examined changes in the rate of surgery and their impact on outcome within the same medical centers over time.METHODS:
The Israel Trauma Registry was searched for patients <18 years who were treated for non-penetrating liver or spleen injuries from 1998 to 2004. Patients were grouped by period, 1998-2000 and 2001-2004, and compared for type of injury, severity of injury, type of treatment, and inpatient mortality.RESULTS:
The earlier period (1998-2000) was characterized by a significantly higher rate of operations compared with the later period (2001-2004) (P = 0.001) and higher in-hospital mortality (P = 0.04). Injury severity scores, type of organs injured, and accompanying injuries were similarly distributed in the two groups.CONCLUSIONS:
Despite the similarity in the severity and characteristics of the intraabdominal injuries in 1998-2000 and in 2001-2004, the proportion of children treated conservatively increased over time, concomitant with a significant drop in inpatient mortality. We attribute this shift over a relatively short interval to increased experience and greater acceptance of conservative management in this setting.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Baço
/
Ferimentos não Penetrantes
/
Traumatismos Abdominais
/
Fígado
Tipo de estudo:
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Pediatr Surg Int
Assunto da revista:
PEDIATRIA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Israel