The management of blunt pancreatic injury in children in New South Wales

Author:

Chung Sally T W,Holland Andrew J AORCID,Brown JulieORCID,Adams Susan E

Abstract

AbstractBackgroundBlunt pancreatic injury is uncommon but associated with considerable morbidity. The optimal management strategy for children with this injury remains unclear, with laparotomy rates in North America of up to 55%. This has not been studied at a population level in Australia. This study aimed to examine the management of children with blunt pancreatic injury in New South Wales (NSW), Australia.MethodsUsing the NSW Admitted Patient Data Collection from 2001 to 2019, we identified patients <16 years old with blunt pancreatic injury. Cases were categorised as undergoing non-operative or operative management. Patient and injury characteristics and outcomes were compared between non-operative and operative groups. Independent predictors of operative management were identified using multivariable logistic regression.Results139 cases were identified: 37 (26.6%) underwent operative management, of whom 11 (29.7%) had a pancreas-specific operation. Two-thirds were managed at a paediatric trauma centre. Operation rates were highest in adult trauma centres, although treatment outside a paediatric trauma centre overall was not associated with operative management. Independent predictors of operative management were high-grade pancreatic injury, hollow viscus injury and transfusion. Morbidity and mortality were 30.2% and 1.4%, respectively.ConclusionBlunt pancreatic injury continues to carry substantial morbidity. Operation rates in NSW are lower than those reported in North America, with similar outcomes. Unlike other solid organ injuries, most children are managed at paediatric trauma centres. Future studies should investigate factors driving management decisions in the Australian context, with the aim of developing paediatric guidelines promoting non-operative management.HighlightsOperation rates for children with BPI were much lower than reported in international studies, with comparable morbidity and lower mortality.Operation rates were highest at ATCs, although, overall, children with BPI managed outside PTCs were not more likely to undergo an operation.Penetrating pancreatic injury is rare compared to the US, likely reflecting that firearm-related injury in Australia remains uncommon.

Publisher

Cold Spring Harbor Laboratory

Reference88 articles.

1. Australian Institute of Health and Welfare. Causes of death. Australia’s Health 2020. Canberra: Australian Institute of Health and Welfare; 2020. https://www.aihw.gov.au/reports/australias-health/causes-of-death

2. Centers for Disease Control and Prevention. Leading Causes of Death Reports, 1981-2019. 2020. https://webappa.cdc.gov/sasweb/ncipc/leadcause.html

3. Epidemiology of Childhood Injuries

4. Management of pancreatic injury in pediatric blunt abdominal trauma

5. Management of blunt pancreatic trauma in children: review of the National Trauma Data Bank;J Pediatr Surg,2016

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3