Pediatric blunt cardiac injury : epidemiology, clinical features, and diagnosis.
The goal of this study was to describe the epidemiology, clinical presentation, diagnostic methods, and outcome in a large series of children with blunt cardiac injury (BCI).
A multicenter retrospective review of all individuals less than 18 years of age diagnosed with a BCI from 1983 to 1993 was conducted.
Cases included all those with a discharge diagnosis of myocardial contusion, concussion, ventricular disruption, or unspecified BCI.
A total of 184 cases of BCI were identified in 16 participating centers.
The median age was 7.4 years, and 73% were male.
Myocardial contusions accounted for 95% of the diagnoses.
The leading mechanisms were motor vehicle crashes involving a pedestrian (39.7%) or passenger (31.0%). The majority (87%) had multiple system trauma, with a mean Injury Severity Score of 27.2 (SD rhô 14.4).
Pulmonary contusions were present in 50.5% and rib fractures in 23.0%. The most common diagnostic test performed was a 12-lead electrocardiogram (EKG) (82%), followed by a MB band of creatine phosphokinase (CPK-MB) (69%) and echocardiogram (65%). All three tests were performed in 50%. In these patients, agreement among various diagnostic test pairs was fair (echocardiogram vs.
EKG, Ø=0.27) to poor (echocardiogram vs.
CPK-MB, Ø=-0.07 and EKG vs.
No hemodynamically stable patient who presented with a normal sinus rhythm subsequently developed a cardiac arrhythmia or cardiac failure.
There were 25 deaths...
Mots-clés Pascal : Traumatisme, Coeur, Enfant, Homme, Epidémiologie, Diagnostic, Pronostic, Santé publique, Cardiopathie, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Trauma, Heart, Child, Human, Epidemiology, Diagnosis, Prognosis, Heart disease, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0143153
Code Inist : 002B16A. Création : 199608.