Abstract:
OBJECTIVES:Nonoperative management of hemodynamically stable liver lacerations in pediatric trauma patients is a safe and effective management strategy for pediatric patients; approximately 90% will be successfully managed nonoperatively. No study has specifically identified risk criteria for the need for intervention versus observation alone. Our objective for this study was to determine risk factors from the physical examination, computed tomography scan, and laboratory results associated with intervention for liver laceration. METHODS:We performed a retrospective cohort study using data from the Pediatric Emergency Care Applied Research Network Intra-abdominal Injuries Study public use data set. Data were collected prospectively at the time of enrollment; a limited data set was released for public use in 2014. Patients were included if they were diagnosed with a liver laceration by computed tomography scan. We used bivariable and multivariable analyses to determine associations of specific risk factors with intervention, defined as laparotomy, angiographic embolization, blood transfusion, death, or return to emergency department for any reason within 30 days. RESULTS:Of the 12,044 patients in the Intra-abdominal Injuries Study, 282 were diagnosed with a liver laceration. All patients were hospitalized, and 99 (35.1%) underwent an intervention. Variables were then eliminated if more than 10% of cases were missing data. Multivariable logistic regression identified the following independent risk factors for intervention: white blood cell count greater than 15 K/mcl (adjusted odds ratio [adjOR], 2.83; 95% confidence interval [CI], 1.43-5.63), pelvic fracture (adjOR, 2.50; 95% CI, 1.02-6.10), liver injury greater than grade 2 (adjOR, 2.16; 95% CI, 1.06-4.40), Glasgow Coma Scale score less than 15 (adjOR, 4.77; 95% CI, 2.27-7.63), and hematocrit less than 32% (adjOR, 4.79; 95% CI, 2.00-11.46). CONCLUSIONS:We identified 5 high-risk criteria associated with intervention for traumatic liver laceration in pediatric patients. Prospective studies are necessary to validate these results before using them to determine disposition of pediatric patients with traumatic liver injuries.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Donnelly KA,Breslin K,OʼConnell KJdoi
10.1097/PEC.0000000000001538subject
Has Abstractpub_date
2020-07-01 00:00:00pages
e373-e377issue
7eissn
0749-5161issn
1535-1815journal_volume
36pub_type
杂志文章abstract::Omeprazole; the first proton pump inhibitor (PPI) showing an effective acid inhibitory ability, provides the satisfactory therapy either in gastro-esophageal reflux symptom relief or in healing of erosive esophagitis. It's also effective in peptic ulcer disease. Up to date, omeprazole efficacy and safety are well esta...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000173350.45648.9b
更新日期:2005-08-01 00:00:00
abstract::Necrotizing soft tissue infections are a serious medical emergency that involve necrosis within the soft tissue space including the dermis, subcutaneous tissue, superficial fascia, deep fascia, and muscle. Inciting factors include recent varicella infection, omphalitis, trauma, intramuscular injections, perianal traum...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001888
更新日期:2019-08-01 00:00:00
abstract::Expected clinical manifestations of intussusception include paroxysmal abdominal pain, vomiting, abdominal mass, and with time, rectal bleeding. We report a case where lethargy and vomiting are the presenting complaints. Diagnostic delay was encountered for this infant who had altered sensorium without accompanying pa...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198706000-00015
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:Forearm fractures are common injuries in children. Displaced and angulated fractures usually require reduction. Ultrasound diagnosis and guided reduction offer several potential advantages: (1) the procedure does not involve ionizing radiation; (2) compared with fluoroscopy units, the newer ultrasound units ...
journal_title:Pediatric emergency care
pub_type: 临床试验,杂志文章
doi:10.1097/PEC.0b013e318128f85d
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVES:To determine the percentage of cases of epididymitis in pediatric patients that is of bacterial cause and to identify factors that predict a positive urine culture. METHODS:We conducted a retrospective chart review of patients diagnosed with acute epididymitis or epididymo-orchitis in 1 pediatric emergency ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31820d647a
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:To determine the relationship between mothers' use of prenatal care and pediatric emergency department (ED) use by their infants in the first 3 months of life. METHODS:This is a retrospective, cohort-control study of well, full-term infants who use a children's hospital ED. Using logistic regression, the lik...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200006000-00004
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVES:To develop and validate predictive models to determine the need for hospitalization in children treated for acute asthma in the emergency department (ED). METHODS:Prospective cohort study of children aged 2 years and older treated at 2 pediatric EDs for acute asthma. The primary outcome was successful ED di...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e31818c268f
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Acute appendicitis is the most common surgical emergency during childhood. Accurate early diagnosis is important to avoid complications and unnecessary interventions. In 2002, Samuel developed the Pediatric Appendicitis Score (PAS) based on a series of data obtained from anamnesis, physical examination, and ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182586d34
更新日期:2012-06-01 00:00:00
abstract::Primary tumors of the esophagus are extremely rare in children. A common periesophageal mass in children is duplication. It constitutes only 0.5 to 2.5% of all esophageal lesions usually diagnosed in infancy or early childhood. Duplication of the esophagus may be diagnosed on examination by the emergency department (E...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of and to identify factors associated with prolonged emergency department length-of-stay (ED-LOS) for admitted children. METHODS:Data were from the 2001-2006 National Hospital Ambulatory Medical Care Survey. The primary outcome was prolonged ED-LOS (defined as total ED time >8 hour...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31820943e4
更新日期:2011-02-01 00:00:00
abstract::Emergency department (ED) overcrowding has been a serious issue on the national agenda for the past 2 decades and is rapidly becoming an increasingly significant problem for children. The goal of this report is to focus on the issues of overcrowding that directly impact children. Our findings reveal that although over...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000280518.36408.74
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVES:Children returning to the emergency department (ED) within 72 hours of their visit may increase overcrowding and health care costs. Identifying the characteristics of returning children who need admission may help distinguish who might need admission on their first visit. The objective of this study was to c...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31822c1273
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment. METHODS:We conducted a prospective, randomized comparison of treatments of fecal impaction in children in a pediatric emergency department (ED). Treatment arms were a single milk and m...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/PEC.0b013e3182442c0a
更新日期:2012-02-01 00:00:00
abstract::Children who have been sexually abused develop a variety of emotional and physical complaints, often unrelated to the genital area. Emergency department records of children diagnosed as being sexually abused were reviewed for the period covering January 1984 through June 1985. Of 26,000 patients seen, 300 cases of sex...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198609000-00002
更新日期:1986-09-01 00:00:00
abstract::Herlyn-Werner-Wunderlich (HWW) syndrome is a rare müllerian duct anomaly with uterus didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis. Patients with this syndrome generally present after menarche with pelvic pain and mass and, rarely, primary infertility in later years. Strong suspicion and ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000052
更新日期:2014-01-01 00:00:00
abstract::The sting from Centuroides sculpturatus, commonly known as the bark scorpion, is a serious medical problem and can be potentially fatal to young children. Centuroides sculpturatus envenomation can cause a wide spectrum of symptoms, often including autonomic dysfunction, cranial nerve abnormalities, and somatic motor a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001301
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:To determine outpatient pediatricians' self-reported experience with and preparation for patient emergencies, and their awareness of the American Academy of Pediatrics (AAP) policy statement on outpatient emergency preparedness. METHODS:A 34-question cross-sectional survey of outpatient pediatric faculty and...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000310
更新日期:2015-07-01 00:00:00
abstract::Alcaligenes faecalis is a gram-negative organism that is commonly found in the environment and may also be a part of normal fecal flora in humans. Although various infections with this bacteria have been described in the pediatric population, it has not been previously identified in infections as the pathogen after a ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000645
更新日期:2017-07-01 00:00:00
abstract::Pediatric bilateral facial nerve paralysis (FNP) is a rare condition, representing less than 2% of all cases of FNP. The differential diagnosis of FNP is extensive (ranging from infectious, traumatic, neurologic, to idiopathic) and often can present as a diagnostic challenge. In contrast to unilateral presentation, bi...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001648
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVES:The objectives of the study were to identify factors associated with adolescent emergency department (ED) visits for substance abuse, including those complicated by mental health (dual diagnosis), and to analyze their effect on ED length of stay (LOS) and disposition. METHODS:We performed a secondary analys...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000421
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:Human immunodeficiency virus (HIV) continues to be a significant public health concern for adolescents and young adults. Since 2006, the Centers for Disease Control and Prevention has recommended more aggressive routine screening for HIV for patients presenting to the emergency department (ED). Our objectives...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182767add
更新日期:2012-12-01 00:00:00
abstract::Malignant hypertension due to autonomic dysfunction is a known complication of Guillain-Barré syndrome. We describe a child who presented with status epilepticus secondary to hypertensive encephalopathy who, in recovery, was found to be areflexic. Nerve conduction studies confirmed the clinical diagnosis of Guillain-B...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31814b2ddd
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:This study aimed to determine the prevalence of complementary health approaches (CHAs) specifically for acute complaints in patients assessed in a pediatric emergency department (ED) and factors associated with use. METHODS:A cross-sectional survey was offered to patients between the age of 28 days and 18 ye...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001424
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:The objective was to derive a simple clinical scoring instrument for assessing children with croup by telephone for use in clinical research studies. METHODS:We reviewed published literature on croup scores, surveyed experienced pediatric emergency nurses and physicians, and conducted a prospective cohort st...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000796
更新日期:2016-05-01 00:00:00
abstract::A case report of an 11-month-old infant with cocaine intoxication and intussusception is presented. We present this case because there are no prior reports in the literature of cocaine intoxication associated with intussusception. The diagnosis was not initially considered in this patient. We feel the association is b...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199412000-00010
更新日期:1994-12-01 00:00:00
abstract::Etizolam (ETZ) is an antidepressive thienodiazepine drug that is used worldwide. The most frequent adverse effects in adults are drowsiness and muscle weakness, and this can rarely cause paradoxical excitation; however, no information exists on intoxication in children. Furthermore, evidence bearing on its safety in c...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000280511.13537.bd
更新日期:2007-07-01 00:00:00
abstract::A 6-year-old boy presented to the pediatric emergency department with a unilateral 5 × 3-cm superficial mass on the postauricular region growing for 1 month. Point-of-care ultrasound was used to evaluate the mass, which revealed a complex cystic mass penetrating the temporal bone. After confirmatory magnetic resonance...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001092
更新日期:2017-04-01 00:00:00
abstract::A case history of a young girl who sustained a small posterior laceration of her cervical trachea after blunt trauma is presented. She was brought to the emergency department (ED) by her parents roughly two hours after the incident with only minor symptoms. While in the ED, she developed significant airway compromise ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199110000-00008
更新日期:1991-10-01 00:00:00
abstract::The diagnosis of septic arthritis should be considered in all children with hip pain. We review the evaluation of children who present with fever and hip pain, emphasizing features that may assist in distinguishing septic arthritis of the hip from transient synovitis. We also discuss the impact of the increased preval...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000159063.24820.73
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVES:The aim of this study is to explore current community emergency department (ED) experiences available to pediatric emergency medicine (PEM) trainees and estimate the proportion of graduates taking positions that involve working in a community ED setting. METHODS:We conducted an e-mail-based survey among PEM...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001349
更新日期:2020-10-01 00:00:00