Variability in the evaluation of pediatric blunt abdominal trauma.
Document Type
Article
Publication Date
4-1-2019
Identifier
DOI: 10.1007/s00383-018-4417-z
Abstract
PURPOSE: To describe the practice pattern for routine laboratory and imaging assessment of children following blunt abdominal trauma (BAT).
METHODS: Children (age < 16 years) presenting to 14 pediatric trauma centers following BAT over a 1-year period were prospectively identified. Injury, demographic, routine laboratory and imaging utilization data were collected. Descriptive, comparative, and correlation analysis was performed.
RESULTS: 2188 children with a median age of 8 (4,12) years were included and the median injury severity score was 5 (1,10). There were significant differences in activation status, injury severity, and mechanism across centers; however, there was no correlation of level of activation, injury severity, or severe mechanism with test utilization. Routine laboratory and imaging utilization for hematocrit, hepatic enzymes, pancreatic enzymes, base deficit urine microscopy, chest and pelvis X-ray, and abdominal computed tomography (CT) varied significantly among centers. Only obtaining a hematocrit had a moderate correlation with CT use. There was no correlation between centers that were high or low frequency laboratory utilizers with CT use.
CONCLUSIONS: Wide variability exists in the routine initial laboratory and imaging assessment in children following BAT. This represents an opportunity for quality improvement in pediatric trauma.
LEVEL OF EVIDENCE: Level II.
Journal Title
Pediatric surgery international
Volume
35
Issue
4
First Page
479
Last Page
485
MeSH Keywords
Abdominal Injuries; Adolescent; Child; Female; Humans; Injury Severity Score; Male; Quality Improvement; Reproducibility of Results; Retrospective Studies; Tomography, X-Ray Computed; Trauma Centers; Wounds, Nonpenetrating
Keywords
Blunt abdominal trauma; Pediatric; Variability
Recommended Citation
Vogel AM, Zhang J, Mauldin PD, et al. Variability in the evalution of pediatric blunt abdominal trauma. Pediatr Surg Int. 2019;35(4):479-485. doi:10.1007/s00383-018-4417-z