AI Article Synopsis
- The study assesses surgical management of pediatric lower extremity vascular injuries (PLEVI) at adult versus pediatric trauma centers.
- Between 2009 and 2022, data from 79 patients were reviewed, focusing on outcomes like amputation and fasciotomy rates.
- Results show that although injury patterns varied between centers, overall outcomes were similar, indicating that PLEVI can be effectively treated in both types of facilities.
Article Abstract
Background: Pediatric lower extremity vascular injury (PLEVI) is uncommon and the availability of granular data is sparse. This study evaluated the surgical management of PLEVIs between a Level I adult (ATC) vs pediatric (PTC) trauma center.
Methods: We performed a retrospective review of PLEVIs (< 18 years) managed surgically between 01/2009-12/2022. Demographics and outcome data were obtained. Primary outcomes included amputation and fasciotomy rates. Secondary outcomes included type of vessel repair, mortality, and hospital length of stay.
Results: Seventy-nine patients were identified, 41 at the ATC and 38 at the PTC, totaling 112 vessels injured. ATC patients were older (median years 16.0 vs 12.5) and almost exclusively (97.6% vs 29.0%) gunshot wounds. Vascular surgeons managed 50% of injuries at the ATC vs 73.7% at the PTC (p = 0.10). Amputations were uncommon and not significantly different between centers. Seventeen patients (44.7%) required fasciotomies at the PTC vs 21 (51.2%) at the ATC (p = 0.56). Rates of vessel repair, ligation, grafting, mortality, and hospital length of stay were not significantly different.
Conclusions: PLEVI can be managed safely at ATCs and PTCs with acceptable outcomes. However, important nuances in patient triage and management need to be considered. Multi-institutional comprehensive datasets are needed.
Level Of Evidence: Level III.
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| http://dx.doi.org/10.1007/s00383-024-05837-3 | DOI Listing |
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