Early ambulation in solid intra abdominal organ injury following blunt abdominal trauma in paediatric patients

Abstract

BackgroundUncertainty exists surrounding the optimal time for ambulation in paediatric patients who have been conservatively managed post intra-abdominal solid organ injury (IASOI) following blunt abdominal trauma, specifically the safety of early ambulation. This study aims to assess the safety of early ambulation in this population. MethodsA single centre retrospective chart review of paediatric patients 15 years old and younger over a 10-year period 01 January 2010 – 31 December 2020 was conducted. Data was collected regarding demographics, time to ambulation, mean length of stay (LOS), Mechanism of Injury (MOI), need for intervention (operative, interventional radiological or medical), opiate analgesia prescription on discharge, and time to return to full physical activity. Logistical regression using Fishers Exact test was used in statistical analysis. ResultsOf the 138 patients included in the study, 115 (83%) sustained an isolated IASOI and 23 (17%) a multiple IASOI. The mean grade of injury for both isolated and multiple IASOI was 3.0. The mean time to ambulation was 2.5 days in isolated IASOI and 2.8 in multiple IASOI. In isolated IASOI, with the exception of pancreatic injures for all other organs over all grades, the mean time to ambulation in children was prior to the grade + rule in days. There were 6 complications (4%) requiring intervention (operative or interventional radiology). There were no cases of delayed haemorrhage in our study population. ConclusionEarly ambulation in isolated IASOI is safe and does not lead to clot destabilization and further haemorrhage requiring intervention. Level of evidenceIII