Non-operative management of isolated solid organ injuries due to blunt abdominal trauma in children

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dc.contributor.authorOzturk, H
dc.contributor.authorDokucu, AI
dc.contributor.authorOnen, A
dc.contributor.authorOtçu, S
dc.contributor.authorGedik, S
dc.contributor.authorAzal, OF
dc.date.accessioned2024-04-24T16:24:10Z
dc.date.available2024-04-24T16:24:10Z
dc.date.issued2004
dc.departmentDicle Üniversitesien_US
dc.description.abstractThe purpose of this study was to evaluate essential prerequisites for a selective non-operative approach in children with solid organ injuries due to blunt abdominal trauma, and to determine the predictive value of two different trauma scoring systems: the Injury Severity Score (ISS) and the Paediatric Trauma Score (PTS). A retrospective review of children who were admitted with blunt abdominal solid organ injuries to a paediatric trauma Centre between January 1986 and September 2001 was performed. Hepatic, splenic, and renal injuries were graded, based on the American Association for the Surgery of Trauma (AAST) Organ Injury Scale (ranged from grade I to IV). The patients were treated non-operatively or operatively and the two groups were compared for variables such as age, blood transfusion, ISS, PTS, length of hospitalisation, morbidity and mortality rate. Two hundred and five patients (147 boys and 58 girls) entered in this study. Median age was 7 years (1 - 15 yrs). The most common cause of trauma was falls (50%). Abdominal organ injuries were present in all patients with the spleen as the most commonly injured organ (111 patients). Fifty-one patients (32%) had additional extra-abdominal organ injuries. Thirty-five (17%) patients were treated operatively, while 170 (83%) were treated non-operatively. Post-traumatic complications developed in 10 patients treated operatively versus 4 patients treated non-operatively. Four patients died due to multiple organ failure (2 non-operative, 2 operative). When compared to the non-operative group, higher transfusion requirements (p < 0.05), a higher ISS (p < 0.01), lower PTS values (p = 0.0001), a longer hospitalisation period (p = 0.0001), and a higher complication rate (p < 0.05) were observed in the operative group. in addition, the non-operative treatment approach was more common in the last five years compared to the previous ten years (p = 0.002). In conclusion, the appropriate non-operative management of injured children reduces the risks of blood transfusion and decreases the length of hospital stay compared with a surgical approach. The use of physiological parameters and radiological findings may be sufficient criteria for observing haemodynamically stable patients with isolated abdominal organ injuries, and thus intensive care unit costs may be avoided. In addition, a careful and close follow-up is essential in injured patients with a low PTS or high ISS.en_US
dc.identifier.doi10.1055/s-2004-815777
dc.identifier.endpage34en_US
dc.identifier.issn0939-7248
dc.identifier.issue1en_US
dc.identifier.pmid15024676
dc.identifier.scopus2-s2.0-1642388289
dc.identifier.scopusqualityQ1
dc.identifier.startpage29en_US
dc.identifier.urihttps://doi.org/10.1055/s-2004-815777
dc.identifier.urihttps://hdl.handle.net/11468/16548
dc.identifier.volume14en_US
dc.identifier.wosWOS:000220455900007
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherGeorg Thieme Verlag Kgen_US
dc.relation.ispartofEuropean Journal of Pediatric Surgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectPaediatric Traumaen_US
dc.subjectHepatic Traumaen_US
dc.subjectSplenic Traumaen_US
dc.subjectKidney Traumaen_US
dc.subjectNon-Operative Trauma Managementen_US
dc.titleNon-operative management of isolated solid organ injuries due to blunt abdominal trauma in childrenen_US
dc.titleNon-operative management of isolated solid organ injuries due to blunt abdominal trauma in children
dc.typeArticleen_US

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