Pediatric vascular injuries

Acute management and early outcomes

Michael G. Corneille, Theresa M. Gallup, Celina Villa, Jacqueline M. Richa, Steven E. Wolf, John G Myers, Daniel L Dent, Ronald M Stewart

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background: Although uncommon in children, traumatic vascular injuries have the potential for lifelong disability. We reviewed these injuries, their acute management, and early outcomes at a Level I trauma center. Methods: Retrospective review of patients identified through trauma registry was query of all noniatrogenic vascular injuries in a pediatric population during a 13-year period. Demographics, injury type and management, concomitant injuries, and inpatient outcomes were analyzed. Results: From 1995 to 2008, 8,247 children with traumatic injuries were admitted. Of which 116 (1.4%) sustained 138 significant vascular injuries; 111 arterial and 27 venous. Mean age was 12.7 years ± 4.1 years. Penetrating mechanism was more frequent (57.8%; 67 of 116) than blunt (42.2%; 49 of 116). The overall mean injury severity score was 17.3, of which 12.3 ± 11.7 was for penetrating trauma and 24.1 ± 19.3 for blunt trauma. Thirteen of the 36 patients with torso injuries and one with carotid/jugular injury died. The surviving 102 patients sustained 118 vascular injuries (102 arterial and 16 venous). Of this group, 15 (14.6%) had multiple vascular injuries. There were 23 (22.5%) with torso injuries, 72 (70.6%) with extremity injuries, and 7 (6.9%) with cerebrovascular injuries. Primary repair was the most common arterial repair technique for survivors (25.5%, 26 of 102) and was used more frequently in penetrating trauma (35.0%, 21 of 60) than blunt trauma (12.0%, 5 of 42). Limb salvage was 97.4% (113 of 116). Conclusion: Pediatric vascular trauma is uncommon. Penetrating mechanism is more common than blunt. Injuries to the torso carry a high mortality. Limb salvage is almost universal.

Original languageEnglish (US)
Pages (from-to)823-828
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume70
Issue number4
DOIs
StatePublished - Apr 2011

Fingerprint

Vascular System Injuries
Pediatrics
Wounds and Injuries
Torso
Limb Salvage
Neck Injuries
Injury Severity Score
Multiple Trauma
Trauma Centers
Blood Vessels
Survivors
Registries
Inpatients

Keywords

  • Noniatrogenic vascular injury
  • Pediatric trauma
  • Vascular repair

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Pediatric vascular injuries : Acute management and early outcomes. / Corneille, Michael G.; Gallup, Theresa M.; Villa, Celina; Richa, Jacqueline M.; Wolf, Steven E.; Myers, John G; Dent, Daniel L; Stewart, Ronald M.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 70, No. 4, 04.2011, p. 823-828.

Research output: Contribution to journalArticle

Corneille, MG, Gallup, TM, Villa, C, Richa, JM, Wolf, SE, Myers, JG, Dent, DL & Stewart, RM 2011, 'Pediatric vascular injuries: Acute management and early outcomes', Journal of Trauma - Injury, Infection and Critical Care, vol. 70, no. 4, pp. 823-828. https://doi.org/10.1097/TA.0b013e31820d0db6
Corneille, Michael G. ; Gallup, Theresa M. ; Villa, Celina ; Richa, Jacqueline M. ; Wolf, Steven E. ; Myers, John G ; Dent, Daniel L ; Stewart, Ronald M. / Pediatric vascular injuries : Acute management and early outcomes. In: Journal of Trauma - Injury, Infection and Critical Care. 2011 ; Vol. 70, No. 4. pp. 823-828.
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abstract = "Background: Although uncommon in children, traumatic vascular injuries have the potential for lifelong disability. We reviewed these injuries, their acute management, and early outcomes at a Level I trauma center. Methods: Retrospective review of patients identified through trauma registry was query of all noniatrogenic vascular injuries in a pediatric population during a 13-year period. Demographics, injury type and management, concomitant injuries, and inpatient outcomes were analyzed. Results: From 1995 to 2008, 8,247 children with traumatic injuries were admitted. Of which 116 (1.4{\%}) sustained 138 significant vascular injuries; 111 arterial and 27 venous. Mean age was 12.7 years ± 4.1 years. Penetrating mechanism was more frequent (57.8{\%}; 67 of 116) than blunt (42.2{\%}; 49 of 116). The overall mean injury severity score was 17.3, of which 12.3 ± 11.7 was for penetrating trauma and 24.1 ± 19.3 for blunt trauma. Thirteen of the 36 patients with torso injuries and one with carotid/jugular injury died. The surviving 102 patients sustained 118 vascular injuries (102 arterial and 16 venous). Of this group, 15 (14.6{\%}) had multiple vascular injuries. There were 23 (22.5{\%}) with torso injuries, 72 (70.6{\%}) with extremity injuries, and 7 (6.9{\%}) with cerebrovascular injuries. Primary repair was the most common arterial repair technique for survivors (25.5{\%}, 26 of 102) and was used more frequently in penetrating trauma (35.0{\%}, 21 of 60) than blunt trauma (12.0{\%}, 5 of 42). Limb salvage was 97.4{\%} (113 of 116). Conclusion: Pediatric vascular trauma is uncommon. Penetrating mechanism is more common than blunt. Injuries to the torso carry a high mortality. Limb salvage is almost universal.",
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AU - Corneille, Michael G.

AU - Gallup, Theresa M.

AU - Villa, Celina

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AU - Wolf, Steven E.

AU - Myers, John G

AU - Dent, Daniel L

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N2 - Background: Although uncommon in children, traumatic vascular injuries have the potential for lifelong disability. We reviewed these injuries, their acute management, and early outcomes at a Level I trauma center. Methods: Retrospective review of patients identified through trauma registry was query of all noniatrogenic vascular injuries in a pediatric population during a 13-year period. Demographics, injury type and management, concomitant injuries, and inpatient outcomes were analyzed. Results: From 1995 to 2008, 8,247 children with traumatic injuries were admitted. Of which 116 (1.4%) sustained 138 significant vascular injuries; 111 arterial and 27 venous. Mean age was 12.7 years ± 4.1 years. Penetrating mechanism was more frequent (57.8%; 67 of 116) than blunt (42.2%; 49 of 116). The overall mean injury severity score was 17.3, of which 12.3 ± 11.7 was for penetrating trauma and 24.1 ± 19.3 for blunt trauma. Thirteen of the 36 patients with torso injuries and one with carotid/jugular injury died. The surviving 102 patients sustained 118 vascular injuries (102 arterial and 16 venous). Of this group, 15 (14.6%) had multiple vascular injuries. There were 23 (22.5%) with torso injuries, 72 (70.6%) with extremity injuries, and 7 (6.9%) with cerebrovascular injuries. Primary repair was the most common arterial repair technique for survivors (25.5%, 26 of 102) and was used more frequently in penetrating trauma (35.0%, 21 of 60) than blunt trauma (12.0%, 5 of 42). Limb salvage was 97.4% (113 of 116). Conclusion: Pediatric vascular trauma is uncommon. Penetrating mechanism is more common than blunt. Injuries to the torso carry a high mortality. Limb salvage is almost universal.

AB - Background: Although uncommon in children, traumatic vascular injuries have the potential for lifelong disability. We reviewed these injuries, their acute management, and early outcomes at a Level I trauma center. Methods: Retrospective review of patients identified through trauma registry was query of all noniatrogenic vascular injuries in a pediatric population during a 13-year period. Demographics, injury type and management, concomitant injuries, and inpatient outcomes were analyzed. Results: From 1995 to 2008, 8,247 children with traumatic injuries were admitted. Of which 116 (1.4%) sustained 138 significant vascular injuries; 111 arterial and 27 venous. Mean age was 12.7 years ± 4.1 years. Penetrating mechanism was more frequent (57.8%; 67 of 116) than blunt (42.2%; 49 of 116). The overall mean injury severity score was 17.3, of which 12.3 ± 11.7 was for penetrating trauma and 24.1 ± 19.3 for blunt trauma. Thirteen of the 36 patients with torso injuries and one with carotid/jugular injury died. The surviving 102 patients sustained 118 vascular injuries (102 arterial and 16 venous). Of this group, 15 (14.6%) had multiple vascular injuries. There were 23 (22.5%) with torso injuries, 72 (70.6%) with extremity injuries, and 7 (6.9%) with cerebrovascular injuries. Primary repair was the most common arterial repair technique for survivors (25.5%, 26 of 102) and was used more frequently in penetrating trauma (35.0%, 21 of 60) than blunt trauma (12.0%, 5 of 42). Limb salvage was 97.4% (113 of 116). Conclusion: Pediatric vascular trauma is uncommon. Penetrating mechanism is more common than blunt. Injuries to the torso carry a high mortality. Limb salvage is almost universal.

KW - Noniatrogenic vascular injury

KW - Pediatric trauma

KW - Vascular repair

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