scholarly journals A SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS) AND ORGAN DYSFUNCTION IN CHILDREN WITH ABDOMINAL TRAUMA

2020 ◽  
Vol 24 (2) ◽  
pp. 128-133
Author(s):  
Andrey G. Anastasov ◽  
A. V. Scherbinin
Keyword(s):  
Organ Dysfunction ◽  
Abdominal Trauma ◽  
Injury Severity ◽  
Invasive Mechanical Ventilation ◽  
Pediatric Trauma ◽  
Perioperative Period ◽  
Total Leukocyte Count ◽  
Abdominal Injuries ◽  
Clinical Criteria ◽  
Trauma Score

Introduction. To assess SIRS and organ dysfunction in children with abdominal trauma using generally accepted scales is an actual issue for today. Purpose. To verify clinical criteria for SIRS and organ dysfunction in children with abdominal injuries in the perioperative period. Material and methods. 18 patients, aged 6 -12, with injury of their abdominal organs were treated at the Kusch Pediatric Surgery Clinic ( Republican Children’s Clinical Hospital) in Donetsk in 2014-2019. 11 (61.1%) patients with isolated blunt abdominal trauma and injuries of parenchymal organs were taken into Subgroup 1; 7 (38.9%) patients with open abdominal organ trauma and multiple injuries of internal organs - into Subgroup 2. Assessment of mechanical injury severity and prognosis were made using Pediatric Trauma Score (Tepas J.J., 1985) and Revised Trauma Score (Fitzmaurice L.S. 1997). Shock syndrome gradations were made by the FEAST criteria (Fluid Expansion as Supportive therapy) (2017). Results. Nosological configuration of the injury (closed or open, isolated or multiple) as well as the volume and character of surgical intervention were used for defining SIRS severity in children with abdominal injuries. In the perioperative period, parameters characterizing the degree of disorders of vital organs served as unified criteria of organ dysfunction in children with abdominal trauma. Conclusion. Before surgery, the most informative indexes were: tachypnea RR > 18.0 per min, SpO2/FiO2 < 264, HR > 130.0 beats per min, total leukocyte count > 13.5∙109/L or <4.5∙109/L. In the postoperative period: need in the inotropic support of systolic BP within normal limits, invasive / non-invasive mechanical ventilation, oxygen >50% FiO2 to maintain SpO2> 92%, SpO2 / FiO2<264.

scholarly journals Considerations and Evaluations on Abdominal Trauma in Pediatric Age.

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Agron Dogjani ◽  
Kastriot Haxhirexha ◽  
Edvin Selmani ◽  
Hysni Bendo ◽  
Amarildo Blloshmi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Injury Severity Score ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Severity Score ◽  
Injury Severity ◽  
Pediatric Trauma ◽  
Pediatric Age ◽  
Predictive Tool ◽  
Trauma Score

Background: Trauma is the leading cause of morbidity and mortality in pediatric age. Abdominal trauma is the third most frequent cause of trauma injuries in children. The purpose of our study is to discuss BATp epidemiology and its relationship with polytrauma, , to recognize and describe the mechanisms of blunt abdominal trauma in pediatric age and to identify the signs and symptoms that associate it. Material and methods: In this retrospective study we reviewed all patients with blunt abdominal trauma in pediatric age who presented in Emergency Department at the University Hospital of Trauma in Tirana, Albania in the period between December 1-st 2017 and June 24-th 2018. The sample in the study was taken randomly. The Injury Severity Score, Revised Trauma Score were used as important points to evaluate gravity of injuries, and method of treatment. The data was introduced in absolute and percentage values and Kendal's tau b correlation coefficient and the regression analysis was used to analyze and to find out any association among the dependent versus independent variable. The type of study is case control with two components; descriptive and analytical. Results: In the time period that we studied, about 25200 patients were presented in Emergency department and 6.68% of these cases were hospitalized. Most frequent causes were motor vehicle accidents (35.4%) and abdominal trauma comprised 25.8% of cases, whereas in children it comprised 13.7% of total pediatric trauma. We have found correlation between the injury severity score and complications rate (r = 0.254, n = 49, p <0.001), and injury severity score with length of hospital stay (r = 0279, n = 49, p <0.001). Conclusions: Blunt Abdominal Trauma in pediatric age is a serious threat to the health of the children. Their treatment should be carried out not only in tertiary trauma centers but in every regional hospital. The trauma score is very valuable to determine the gravity of the injury, method of treatment and is a predictive tool in trauma outcomes.

Comparison of Scoring Systems for Mortality Prediction in Pediatric Multitrauma Patients

2021 ◽  
Author(s):  
Mehmet Çelegen ◽  
Kübra Çelegen
Keyword(s):  
Injury Severity ◽  
Pediatric Trauma ◽  
Pediatric Intensive Care ◽  
Scoring Systems ◽  
International Normalized Ratio ◽  
Mortality Prediction ◽  
Risk Scores ◽  
Mortality Ratio ◽  
Risk Predictors ◽  
Trauma Score

AbstractThe aim of this study was to compare scoring systems for mortality prediction and determine the threshold values of this scoring systems in pediatric multitrauma patients. A total of 57 multitrauma patients referred to the pediatric intensive care unit from January 2020 to August 2021 were included. The pediatric trauma score (PTS), injury severity score (ISS), base deficit (B), international normalized ratio (I), Glasgow coma scale (G) (BIG) score, and pediatric risk of mortality 3 (PRISM 3) score were analyzed for all patients. Of the study group, 35% were females and 65% were males with a mean age of 72 months (interquartile range: 140). All groups' mortality ratio was 12.2%. All risk scores based on mortality prediction were statistically significant. Cutoff value for PTS was 3.5 with 96% sensitivity and 62% specificity; for the ISS, it was 20.5 with 92% sensitivity and 43% specificity; threshold of the BIG score was 17.75 with 85.7% sensitivity and 34% specificity; and 12.5 for PRISM 3 score with 87.6% sensitivity and 28% specificity. PTS, ISS, BIG score, and PRISM 3 score were accurate risk predictors for mortality in pediatric multitrauma patients. ISS was superior to PTS, PRISM 3 score, and BIG score for discrimination between survivors and nonsurvivors.

Evaluation of Injury Severity: Review of the Most Commonly Used System for the Evaluation of Injury Severity in Traumatologic Patients

2003 ◽  
Vol 10 (3) ◽  
pp. 16-19 ◽  
Author(s):  
A Karlbauer ◽  
R Woidke ◽  
A Karlbauer ◽  
R Woidke
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Pediatric Trauma ◽  
Abbreviated Injury Scale ◽  
Coma Scale ◽  
Advantages And Disadvantages ◽  
Revised Trauma Score ◽  
Golden Standard ◽  
Trauma Score

The most commonly used systems for the evaluation of injury severity in traumatologic patients are presented: Glasgo Coma Scale, Mangled Extremity Severity Score, Revised Trauma Score, Abbreviated Injury Scale, Injury Severity Score, Pediatric Trauma Score. Their advantages and disadvantages are given. At present Injury Severity Score is considered to be a «Golden Standard.

The pediatric trauma score as a predictor of injury severity in the injured child

1987 ◽  
Vol 22 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Joseph J. Tepas ◽  
Daniel L. Mollitt ◽  
James L. Talbert ◽  
Michael Bryant
Keyword(s):  
Injury Severity ◽  
Pediatric Trauma ◽  
Injured Child ◽  
Trauma Score

scholarly journals Lesões abdominais nos traumatizados com fraturas de bacia

2002 ◽  
Vol 29 (3) ◽  
pp. 153-160 ◽  
Author(s):  
José Gustavo Parreira ◽  
Luciana Haddad ◽  
Samir Rasslan
Keyword(s):  
Injury Severity Score ◽  
Abdominal Trauma ◽  
Severity Score ◽  
Injury Severity ◽  
Organ Injury ◽  
Abbreviated Injury Scale ◽  
Revised Trauma Score ◽  
Trauma Score

OBJETIVO: Analisar as lesões abdominais e seu impacto no prognóstico dos traumatizados com fraturas de bacia MÉTODO: Avaliamos retrospectivamente todos os prontuários das vítimas de trauma fechado com fraturas de bacia admitidos de 1996 a 2000. Nossa amostra incluiu 224 doentes, com média etária de 34 + 16 anos, sendo 137 (61,1%) do sexo masculino. Dados demográficos, índices de trauma, órgãos lesados, tratamento e evolução foram estudados. As lesões abdominais foram estratificadas pela Organ Injury Scale (OIS), Abbreviated Injury Scale (AIS) e Abdominal Trauma Index (ATI). Empregamos os testes Qui quadrado e t de Student, considerando p<0,05 como significativo. RESULTADOS: O mecanismo de trauma mais comum foi o atropelamento, em 119 casos (53%). As médias dos Revised Trauma Score (RTS) e Injury Severity Score (ISS) foram 7,0341+1,864 e 20,2 + 12,8. As lesões abdominais ocorreram em 95 (42,4%) doentes, sendo a bexiga o órgão mais freqüentemente lesado (11%). Sessenta e três (28,1%) traumatizados tiveram AIS> 3 e 54 (24,1%) OIS > 3 em órgãos abdominais. A média dos ATI foi 9 + 8 nos com lesões abdominais diagnosticadas. Foram realizadas 55 laparotomias (nove não terapêuticas). Cinqüenta e um (22%) doentes morreram, principalmente devido ao choque hemorrágico (25 casos). A presença de lesões abdominais esteve relacionada significativamente com choque à admissão, fraturas complexas de bacia, fixação externa ou interna da fratura de bacia, maior morbidade e letalidade. CONCLUSÃO: As lesões abdominais são freqüentemente associadas às fraturas de bacia, e, quando presentes, relacionam-se a um pior prognóstico.

scholarly journals Predictors of Surgical Outcome of Abdominal Trauma in Tertiary Care Centres of Nepal

2017 ◽  
Vol 15 (2) ◽  
pp. 54-61
Author(s):  
Bikash Bikram Thapa ◽  
Rajan Gurung ◽  
Robin Basnet ◽  
Narayan Thapa
Keyword(s):  
Abdominal Trauma ◽  
Surgical Outcome ◽  
Injury Severity ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Trauma System ◽  
Abdominal Injury ◽  
Organ Injury ◽  
Female Ratio ◽  
Trauma Score

Introduction: The abdominal trauma is a surgical emergency most of which are preventable and many of them could have good outcome with timely management by dedicated trauma system. It is not only the rising health problem but also the social and economic burden. A study on abdominal trauma can guide to cost-effective quality management of the patients. This study is undertaken to study and evaluate the predictors of surgical outcome in abdominal trauma patients in tertiary care centers in Nepal.Methods: Seventy five patients with abdominal trauma who underwent surgical intervention were evaluated prospectively inside the inclusion criteria. Ethical approval was obtained. The data on demographic pattern, clinic-radiological findings, abdominal trauma index, injury severity scale, operative findings, infectious complications, and mortality were collected. Chi square test was used for statistical analysis. Results: Out of 75 patients male to female ratio was 4.6 : 1. Blunt trauma (49) was the common cause of abdominal injury. Accidental abdominal injury happened in 73% (55) and fall from height was common mode of abdominal organ injury 40% (30). The overall morbidity and mortality were 30.6% and 9.3% respectively. Age > 30 years, Shock at presentation, Operative Delay > 24 hours, and trauma score (ATI>15 and ISS>15) were all good predictors of surgical outcome of patients with abdominal trauma (p <0.05).Conclusion: The predictors of surgical outcome were patient’s age, clinical status at presentation and delay in surgical intervention. Trauma score (both ATI and ISS) are equally important in predicting outcome which are necessary for monitoring patients care and the quality of trauma systems.

The Pediatric Trauma Score as a Predictor of Injury Severity: An Objective Assessment

1988 ◽  
Vol 28 (4) ◽  
pp. 425-429 ◽  
Author(s):  
JOSEPH J. TEPAS ◽  
MAX L. RAMENOFSKY ◽  
DANIEL L. MOLLITT ◽  
BRUCE M. GANS ◽  
CARLA DiSCALA
Keyword(s):  
Injury Severity ◽  
Objective Assessment ◽  
Pediatric Trauma ◽  
Trauma Score

scholarly journals Laparoscopy for blunt abdominal trauma: a challenging endeavor

2018 ◽  
Vol 108 (4) ◽  
pp. 273-279 ◽  
Author(s):  
M. Z. Koto ◽  
O. Y. Matsevych ◽  
F. Mosai ◽  
S. Patel ◽  
C. Aldous ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Injury Severity ◽  
Length Of Hospital Stay ◽  
Trauma Patients ◽  
Therapeutic Laparoscopy ◽  
The Mean ◽  
Trauma Score

Background and Aims: Laparoscopy in blunt abdominal trauma is challenging because of multiple associated injuries, higher trauma score values and higher morbidity and mortality, as compared with patients with penetrating abdominal trauma. The aim of this study was to investigate the role of laparoscopy in the management of blunt abdominal trauma patients and to highlight related challenges. Material and Methods: Over a 4-year period, patients managed laparoscopically for blunt abdominal trauma were retrospectively analyzed. Perioperative details, indications for laparoscopy and conversion, complications, and length of hospital stay were discussed. Results: A total of 35 stable patients underwent laparoscopy. The mean Injury Severity Score was 12 (4–38). Therapeutic laparoscopy was performed in 15 (56%) and diagnostic in 12 (44%) patients. Eight (23%) patients were converted to therapeutic laparotomy. Intraoperative bleeding, complex injuries, visualization problem, and equipment failure necessitated conversion. Three (30%) patients with negative computed tomography scan had therapeutic laparoscopy for mesenteric injuries. There were no missed injuries. The mean length of hospital stay was 11 days in both groups. Conclusion: Laparoscopy for stable patients is feasible and safe. Multiple injuries make laparoscopy more difficult, and advanced laparoscopic skills are required. The conversion rate is high; however, the non-therapeutic laparotomies were completely eliminated in this study.

scholarly journals Trauma do pâncreas: fatores preditivos de morbidade e mortalidade relacionados a índices de trauma

2009 ◽  
Vol 46 (4) ◽  
pp. 270-278 ◽  
Author(s):  
Henrique José Virgili Silveira ◽  
Mario Mantovani ◽  
Gustavo Pereira Fraga
Keyword(s):  
Injury Severity Score ◽  
Abdominal Trauma ◽  
Severity Score ◽  
Injury Severity ◽  
Revised Trauma Score ◽  
Trauma Score

CONTEXTO: Embora incomuns, lesões traumáticas do pâncreas estão associadas a significativos níveis de complicações e mortalidade. OBJETIVO: Definir os fatores preditivos de morbidade e mortalidade em pacientes vítimas de trauma pancreático. MÉTODO: Foram estudados 131 pacientes atendidos pela Disciplina de Cirurgia do Trauma no Hospital de Clínicas da Universidade Estadual de Campinas, SP, no período entre janeiro de 1994 a dezembro de 2007, com seus parâmetros epidemiológicos, fisiológicos e anatômicos, sendo comparados e analisados aos fatores preditivos de evolução, com estudo estatístico. RESULTADOS: Trauma penetrante, com predomínio de ferimentos por projétil de arma de fogo ocorreu em 64% dos casos. A maioria, 91,6%, era do sexo masculino e a idade média de 29,8anos. A morbidade global foi de 64,9%, com 29% de complicações diretamente relacionadas ao pâncreas, como fístulas e sangramento. A mortalidade foi de 27,5%, principalmente em decorrência de choque hipovolêmico e falência de múltiplos órgãos e sistemas. Houve maior morbidade e mortalidade em pacientes com lesões complexas (graus IV e V) do pâncreas quando comparadas com lesões menos graves (graus I e II), porém a morbidade e mortalidade neste grupo não foram desprezíveis, devido a valores alterados de escore de trauma revisado ("revised trauma score"), valores elevados de índice de gravidade da lesão ("injury severity score") e "abdominal trauma index". CONCLUSÕES: Valores alterados de "revised trauma score", pressão arterial sistólica menor que 90 mm Hg, valor de "injury severity score" menor ou igual a 15 e valor de "abdominal trauma index" maior ou igual a 25 são fatores relacionados a aumento da morbidade. Valores anormais de "revised trauma score", valores de "injury severity score" e "abdominal trauma index" superiores a 25, pressão arterial sistólica inferior a 90 mm Hg são fatores preditivos de aumento de mortalidade em pacientes vítimas de trauma pancreático. Valores baixos do índice misto, anatômico e fisiológico denominado TRISS, são preditivos de maior morbidade e mortalidade, porém valores elevados deste índice não são preditivos de boa evolução.

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