When is it safe to forgo abdominal CT in blunt-injured children?
Surgery
; 158(2): 408-12, 2015 Aug.
Article
em En
| MEDLINE
| ID: mdl-25999252
ABSTRACT
INTRODUCTION:
CT is the standard modality to diagnose solid organ injury after blunt trauma; however, the associated radiation carries a risk of cancer. We hypothesized that there are patient-specific factors that can identify those children who require abdominal CT.METHODS:
We reviewed all children admitted to 2 pediatric trauma centers after blunt trauma with liver or spleen injury from January 2009 to December 2013. The low-risk group was defined as a Glasgow Coma Scale (GCS) of 15 with normal pediatric age-adjusted shock index (heart rate/systolic blood pressure; SIPA) on presentation, and injury attributable to a single, nonmotorized, blunt force to the abdomen. The at-risk group did not meet these criteria.RESULTS:
We identified 206 children with blunt liver or spleen injury, 101 of whom met the low-risk criteria. Among these 101 children who met the low-risk criteria, there were no deaths, no children required laparotomy, only 1 child required a packed red cell transfusion, and no children required discharge to a rehabilitation facility.CONCLUSION:
Children who present to the emergency department after blunt abdominal trauma by a nonmotorized force with a normal GCS and SIPA are unlikely to have a solid organ injury that will require intervention.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Baço
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Ferimentos não Penetrantes
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Tomografia Computadorizada por Raios X
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Traumatismos Abdominais
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Fígado
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
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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Male
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article