{"title":"美国小儿头颈部创伤：使用国家创伤数据库的趋势、风险因素和结果","authors":"Ashwini Sarathy BS, Jamie Benson BS, Kenny Nguyen BS, Stas Amato MD, Mirabelle Sajisevi MD, Erin T. Ostby MD","doi":"10.1002/lio2.1301","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Pediatric head and neck (HN) trauma is an important contributor to pediatric morbidity, resulting in significant downstream consequences. Few studies provide epidemiological predictors of pediatric HN trauma on a national scale. The present study aims to identify risk factors of HN injury and mortality in the pediatric population.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A retrospective cohort study was conducted for patients (age <18 years) using the US National Trauma Data Bank (NTDB 2007–2019). Demographic, injury, and physiologic outcome data were analyzed. HN injury was defined as a head or neck Abbreviated Injury Scale (AIS) >0. Logistic regression identified independent predictors of mortality following HN trauma.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of the 1.42 million pediatric patients analyzed, 44.05% had HN injury. In patients aged 0–4, the most common mechanism was falls (47.67% in this age group) while in ages 14–17, motor vehicle/transport accidents (MVTs) were the most common mechanism (56.06%). Controlling for demographics, comorbidities, and injury severity, HN injury was associated with increased odds of mortality (OR 2.404, 95% CI 1.530–3.778). HN injury mortality was strongly predicted by firearm exposure (OR 11.28, 95% CI 6.074–20.95), age <4 (OR 1.179, 95% CI 1.071–1.299), and self-insured status (OR 1.977, 95% CI 1.811–2.157).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>NTDB data demonstrate that the percentage of pediatric patients with HN trauma has decreased over the past 12 years although is associated with increased odds of mortality. Age and insurance status predicted mortality from HN trauma, with falls and MVTs being the most common mechanisms of injury. These data have implications for future public health efforts in this patient population.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>3.</p>\n </section>\n </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 4","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.1301","citationCount":"0","resultStr":"{\"title\":\"Pediatric head and neck trauma in the United States: Trends, risk factors and outcomes using the National Trauma Data Bank\",\"authors\":\"Ashwini Sarathy BS, Jamie Benson BS, Kenny Nguyen BS, Stas Amato MD, Mirabelle Sajisevi MD, Erin T. Ostby MD\",\"doi\":\"10.1002/lio2.1301\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Pediatric head and neck (HN) trauma is an important contributor to pediatric morbidity, resulting in significant downstream consequences. Few studies provide epidemiological predictors of pediatric HN trauma on a national scale. The present study aims to identify risk factors of HN injury and mortality in the pediatric population.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A retrospective cohort study was conducted for patients (age <18 years) using the US National Trauma Data Bank (NTDB 2007–2019). Demographic, injury, and physiologic outcome data were analyzed. HN injury was defined as a head or neck Abbreviated Injury Scale (AIS) >0. Logistic regression identified independent predictors of mortality following HN trauma.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of the 1.42 million pediatric patients analyzed, 44.05% had HN injury. In patients aged 0–4, the most common mechanism was falls (47.67% in this age group) while in ages 14–17, motor vehicle/transport accidents (MVTs) were the most common mechanism (56.06%). Controlling for demographics, comorbidities, and injury severity, HN injury was associated with increased odds of mortality (OR 2.404, 95% CI 1.530–3.778). HN injury mortality was strongly predicted by firearm exposure (OR 11.28, 95% CI 6.074–20.95), age <4 (OR 1.179, 95% CI 1.071–1.299), and self-insured status (OR 1.977, 95% CI 1.811–2.157).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>NTDB data demonstrate that the percentage of pediatric patients with HN trauma has decreased over the past 12 years although is associated with increased odds of mortality. Age and insurance status predicted mortality from HN trauma, with falls and MVTs being the most common mechanisms of injury. These data have implications for future public health efforts in this patient population.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Level of Evidence</h3>\\n \\n <p>3.</p>\\n </section>\\n </div>\",\"PeriodicalId\":48529,\"journal\":{\"name\":\"Laryngoscope Investigative Otolaryngology\",\"volume\":\"9 4\",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-07-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.1301\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laryngoscope Investigative Otolaryngology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/lio2.1301\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope Investigative Otolaryngology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/lio2.1301","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
Pediatric head and neck trauma in the United States: Trends, risk factors and outcomes using the National Trauma Data Bank
Introduction
Pediatric head and neck (HN) trauma is an important contributor to pediatric morbidity, resulting in significant downstream consequences. Few studies provide epidemiological predictors of pediatric HN trauma on a national scale. The present study aims to identify risk factors of HN injury and mortality in the pediatric population.
Methods
A retrospective cohort study was conducted for patients (age <18 years) using the US National Trauma Data Bank (NTDB 2007–2019). Demographic, injury, and physiologic outcome data were analyzed. HN injury was defined as a head or neck Abbreviated Injury Scale (AIS) >0. Logistic regression identified independent predictors of mortality following HN trauma.
Results
Of the 1.42 million pediatric patients analyzed, 44.05% had HN injury. In patients aged 0–4, the most common mechanism was falls (47.67% in this age group) while in ages 14–17, motor vehicle/transport accidents (MVTs) were the most common mechanism (56.06%). Controlling for demographics, comorbidities, and injury severity, HN injury was associated with increased odds of mortality (OR 2.404, 95% CI 1.530–3.778). HN injury mortality was strongly predicted by firearm exposure (OR 11.28, 95% CI 6.074–20.95), age <4 (OR 1.179, 95% CI 1.071–1.299), and self-insured status (OR 1.977, 95% CI 1.811–2.157).
Conclusion
NTDB data demonstrate that the percentage of pediatric patients with HN trauma has decreased over the past 12 years although is associated with increased odds of mortality. Age and insurance status predicted mortality from HN trauma, with falls and MVTs being the most common mechanisms of injury. These data have implications for future public health efforts in this patient population.
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