P0209 / #1775: EPIDEMIOLOGY AND RISK FACTORS FOR OPERATIVE MANAGEMENT OF PEDIATRIC ABDOMINAL TRAUMA

Abstract

Aims & Objectives: Nonoperative management of pediatric abdominal trauma has become the standard of care in the last years. In our study we investigated characteristics, management and outcomes of pediatric patients who presented to our emergency department with traumatic abdominal injuries. Methods: Patients under 18 years old with a diagnosis of traumatic abdominal injuries, admitted and managed in our hospital from January 2015 to December 2018 were retrospectively studied. Patients were divided into 2 groups, operated and non-operated, according to initial management. Clinical, laboratory features and outcomes were analyzed. Results: Total number of patients in the study was 47. The majority were male (78.7%) and aged over 10 years (42.5%). Hollow viscera lesion occurred in 14.8% of cases, with 100% surgical approach. Surgical treatment was performed in 31.9% of patients and of these, 66.6% required admission to Pediatric Intensive Care Unit, and had significantly longer length of stay in hospital. Regarding clinical and laboratory features on admission, we observed that: Lactate >= 3mmol/L [RR (IC95%) = 2.71 (1.12;6.54)], tachycardia [RR (IC95%) = 2.76 (1.16;6.51)], International Normalized Ratio >=1.3 [RR (IC95%) = 12.0 (1.61;89.52)], ratio of activated partial thromboplastin time >1.07 [RR (IC95%) = 3.38 (1.63;7.03)] and massive transfusion protocol [RR (IC95%) = 14.9 (2.01;110.73)] were risk factors for surgical management. Conclusions: Signs of shock and coagulopathy on admission were risk factors for operative management of children with traumatic abdominal injuries.