Abstract P-122: SUCCESS RATES OF EXPECTANT CONDUCT IN PEDIATRIC PATIENTS VICTIMS OF CONTUSED ABDOMINAL TRAUMA IN A TERTIARY HOSPITAL OF DF / BRASIL

Abstract

Aims & Objectives: To define the success rate of expectant management (EM) applied in pediatric patients victims of contused abdominal trauma (CAT), comparing mortality rates as also as to identify predictors of the need for surgical intervention (SI). Methods Quantitative / descriptive / retrospective study with pediatric patient charts from 0 to 16 years old, treated in a tertiary hospital by the pediatric surgery team between 2012 and 2016, victims of CAT with liver injury and / or spleen and who underwent SI or EM. Results Analyzed 312 records, 65 selected according to the inclusion criteria, 13.8% underwent a SI in the first 12 hours of hospitalization, 86.1% in the EM, and underwent surgery after 12 hours (4.6%). Mortality in patients submitted to SI was 20%; in patients submitted to EM was 3.6%. Hepatic lesions were related to lighter severity and splenic staging with more severe lesions (p-value = 0.048). The main variable related to the need for an initial SI was low hematocrit at admission (p-value = 0.0156), 27.7% of these patients underwent initial SI and among those with normal hematocrit, only 5.2%. We observed a transfusion ratio with the need for ICU admission (p-value = 0.0124). Conclusions The hemodynamic condition of the patient is a great predictor of the failure of the expectant behavior,demonstrated in this work by the high relation between low hematocrit and the need for surgical intervention. The study confirms the worldwide trend in adopting expectant management in the treatment of CAT and demonstrates a better clinical outcome for patients.