Pelvic Fractures in Children

Although rare, pelvic fractures in children have significant morbidity and mortality. No specific guidelines have been developed for the management of these injuries. We reviewed all trauma patients of age 16 years or younger with pelvic fractures treated at our Level I trauma center over the past 12 years. Of 1008 patients with pelvic fractures, 74 were children. Early hemodynamic instability was seen in 14 per cent of cases. Blood transfusions were required in 26 per cent of cases, angiography in 3 per cent of cases, operations for associated injuries in 46 per cent of cases, operative pelvic fracture fixation in 18 per cent of cases, and intensive care unit care in 58 per cent of cases. Mortality was 5 per cent, mostly from hemorrhage and multiple complex injuries. We conclude that pelvic fractures in children are associated with a high frequency of pelvic bleeding and associated injuries that often require operative interventions and intensive care unit care.

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Impact of Elevated per Cent Carbohydrate-deficient Transferrin at Hospital Admission on Outcomes in Trauma Patients

The American Surgeon ◽

10.1177/000313481007600516 ◽

2010 ◽

Vol 76 (5) ◽

pp. 492-496 ◽

Cited By ~ 2

Author(s):

Brian P. Mckinzie ◽

Cathy L. Worrall ◽

Kit N. Simpson ◽

Deborah J. Couillard ◽

Stuart M. Leon

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Alcohol Consumption ◽

Unit Length ◽

Hospital Charges ◽

Gamma Glutamyl Transferase ◽

Trauma Patients ◽

Carbohydrate Deficient Transferrin ◽

Level I ◽

Glutamyl Transferase

Chronic alcohol consumption has been linked to increased morbidity and mortality in the intensive care unit setting. The purpose of our study was to assess outcomes in trauma patients admitted to our institutional university-affiliated, Level I emergency trauma unit (ETU) with and without per cent carbohydrate-deficient transferrin (%CDT) elevations over a 12-week timeframe. Markers for alcohol consumption including %CDT, gamma glutamyl transferase, and serum osmolality were measured along with the standard trauma laboratory panel on arrival to the ETU. Intensive care unit length of stay (LOS), length of time requiring ventilator support, hospital LOS, total hospital charges as well as incidences of postoperative complications were collected on all patients with a LOS greater than or equal to 48 hours. Demographics between the groups were similar. Drinking histories were more significant in the elevated %CDT group ( P = 0.0006). Patients with elevated %CDT had significantly longer ICU and hospital LOS (5.1 vs 3.9, P = 0.01; 8.7 vs 7.1 days, P = 0.0052) and ventilator days (2 vs 1.5 days, P = 0.0286). Complications and hospital charges were similar between groups. Trauma patients presenting to the ETU with %CDT elevations appear to be at risk for longer ICU and hospital LOS.

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Outcome of Cervical Spine Trauma Patients Admitted to the Intensive Care Unit at a Tertiary Government Referral Trauma Center in Nepal

Global Spine Journal ◽

10.1177/2192568220980703 ◽

2021 ◽

pp. 219256822098070

Author(s):

Gyanendra Shah ◽

Gaurav Raj Dhakal ◽

Anil Gupta ◽

Pawan Kumar Hamal ◽

Siddhartha Dhungana ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Cervical Spine ◽

Cervical Spinal Cord ◽

Limited Resource ◽

Trauma Patients ◽

Cervical Spine Injuries ◽

Resource Setting ◽

Cord Injury ◽

Huge Impact

Study Design: Retrospective study. Objectives: Cervical spinal cord injury (SCI) is a devastating event for patient and family. It has a huge impact on society because of intensive resources required to manage the patient in both acute and rehabilitation phases. With the limited resource setting in underdeveloped countries like Nepal, questions are often raised regarding whether the outcome justifies the expenses of their care. The objective was to assess the outcomes of cervical SCI patients admitted to intensive care unit (ICU). Methods: All cervical SCI admitted in ICU during May 2017 to August 2018 were included in this study. Demographic details, mode, morphology, and neurological level of injury, intervention performed and outcomes of ICU stay were analyzed. Results: Out of 48 patients, 36 (75%) were male and 12 female with mean age 43.9 ± 15.9 years. Fall injury was the commonest mode of injury (83.3%). Most patients presented within 1 to 3 days of injury and C5-C6 (33.3%) was the most common involved level and 75% presented with ASIA A neurology. Mechanical ventilation was required in 95.8% of the patients and 22 patients were operated upon. The average stay in ICU was 15 days and 13 patients died in the ICU. Conclusions: Majority of cervical SCI with complete motor paraplegia required ICU care. Inspite of the intensive care, a subset of these patients succumbed to the complications of the injury. Therefore, it is essential to establish trauma ICU care with specific protocols on managing cervical spine injuries.

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