Opportunity for Reduction of Intensive Care Unit Resource Utilization in Pediatric Blunt Liver and Spleen Injuries: A National Trauma Data Bank Analysis.
J Pediatr Surg
; 59(7): 1309-1314, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38575447
ABSTRACT
INTRODUCTION:
Guidelines for blunt liver and spleen injury (BLSI) by the Arizona-Texas-Oklahoma-Memphis-Arkansas Consortium (ATOMAC) emphasize hemodynamic stability over injury grade when considering non-operative management (NOM). In this study, we examined rates of intensive care unit (ICU) admission for children with isolated low-risk BLSI among US hospitals.METHODS:
The National Trauma Data Bank (NTDB) was queried for patients ages 1-15 admitted between 2017 and 2019 with BLSI. Patients with penetrating injuries and/or concomitant non-abdominal injuries with AIS score ≥3 were excluded. Isolated BLSI was considered low-risk if the patient had normal admission vitals and did not require operative intervention. Primary outcomes measured were ICU admission, ICU length of stay (LOS), and overall LOS.RESULTS:
5777 patients ages 15 and under presented with isolated BLSI during the study period. 2031/5777 (35.2%) were considered low-risk. Low-risk patients had lower rates of ICU admission compared to high-risk patients (30.9% vs. 41.6%, p < 0.001) and had shorter ICU LOS (median 2 days vs. 2, p < 0.001) and shorter overall LOS (median 41 h vs. 54, p < 0.001). Pediatric verified and non-pediatric verified trauma centers had similar rates of ICU admission (36.8% vs. 38.9%, p = 0.11).CONCLUSION:
Further work is needed to capture opportunities for reduction in ICU utilization in isolated BLSI. LEVEL OF EVIDENCE III.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Baço
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Ferimentos não Penetrantes
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Bases de Dados Factuais
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Unidades de Terapia Intensiva
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Tempo de Internação
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Fígado
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article