N. Hernandez1, A. Elkbuli1 1Orlando Regional Medical Center, Trauma Srurgery, Orlando, FL, USA
Introduction:
The aim of this study is to evaluate the clinical outcomes of hemodynamically stable pediatric patients with moderate-severe thoracic trauma requiring emergency department thoracotomy (EDT) treated at pediatric trauma centers (PTC), combined adult/pediatric trauma centers (CTC), and adult-only trauma centers (ATC).
Methods:
The ACS-TQIP database (2017-2021) was utilized in this retrospective cohort analysis to evaluate outcomes among hemodynamically stable pediatric (age < 18) patients with moderate-severe (AIS chest > 2) blunt or penetrating thoracic trauma requiring an (EDT). The primary outcome of interest was mortality (defined as ED, 24-hour, and in-hospital mortality). Outcomes of interest were evaluated by trauma center type.
Results:
A total of 314 patients were identified, with 219 patients (69.7%) treated at ATCs, 77 patients (24.5%) treated at CTCs, and 18 patients (5.7%) treated at PTCs. There was no significant association between 24-hour mortality and treatment at a CTC when compared to treatment at an ATC for patients with penetrating (OR 0.022, 95% CI 0.000-1444.900, p=0.501) or blunt (OR 0.259, 95% CI 0.008-7.978, p=0.440) injuries. There was also no significant association between sustaining a penetrating injury and 24-hour mortality when compared to sustaining a blunt injury (OR 0.793, 95% CI 0.154-4.079, p=0.782).
Conclusion:
Among hemodynamically stable pediatric trauma patients with moderate-severe blunt or penetrating thoracic injuries requiring EDT, our results show comparable mortality outcomes for patients treated at a CTC when compared to an ATC. Additionally, outcomes were comparable for pediatric EDT patients regardless of injury type. Further research is needed to understand potential benefits of performing the procedure in a pediatric trauma center and among hemodynamically unstable patients.