BACKGROUND/ PURPOSE: The urinary bladder is the second most commonly injured genitourinary organ. The objective of this study was to describe the management of pediatric traumatic bladder ruptures in the United States and their association with surgical repair and mortality. METHODS: We searched the 2002-2008 National Trauma Data Bank for all pediatric (<18 years old) subjects with bladder rupture. Demographics, mechanism of injury, coexisting injury severity, and operative interventions for bladder and other abdominal trauma are described. Multivariate logistic regression analysis was used to examine the relationship between bladder rupture and both bladder surgery and in-hospital mortality. RESULTS: We identified 816 children who sustained bladder trauma. Forty-four percent underwent bladder surgery, including 17% with an intraperitoneal injury. Eighteen percent had 2 intra-abdominal injuries, and 40% underwent surgery to other abdominal organs. In multivariate analysis, operative bladder repair reduced the likelihood of in-hospital mortality by 82%. A greater likelihood of dying was seen among the uninsured and those with more severe injuries and multiple abdominal injuries. CONCLUSIONS: After bladder trauma, pediatric patients demonstrate significantly improved survival when the bladder is surgically repaired. With only 67% of intraperitoneal bladder injuries being repaired, there appears to be underuse of a life-saving procedure.
BACKGROUND/ PURPOSE: The urinary bladder is the second most commonly injured genitourinary organ. The objective of this study was to describe the management of pediatric traumatic bladder ruptures in the United States and their association with surgical repair and mortality. METHODS: We searched the 2002-2008 National Trauma Data Bank for all pediatric (<18 years old) subjects with bladder rupture. Demographics, mechanism of injury, coexisting injury severity, and operative interventions for bladder and other abdominal trauma are described. Multivariate logistic regression analysis was used to examine the relationship between bladder rupture and both bladder surgery and in-hospital mortality. RESULTS: We identified 816 children who sustained bladder trauma. Forty-four percent underwent bladder surgery, including 17% with an intraperitoneal injury. Eighteen percent had 2 intra-abdominal injuries, and 40% underwent surgery to other abdominal organs. In multivariate analysis, operative bladder repair reduced the likelihood of in-hospital mortality by 82%. A greater likelihood of dying was seen among the uninsured and those with more severe injuries and multiple abdominal injuries. CONCLUSIONS: After bladder trauma, pediatric patients demonstrate significantly improved survival when the bladder is surgically repaired. With only 67% of intraperitoneal bladder injuries being repaired, there appears to be underuse of a life-saving procedure.
Authors: B Phillips; S Holzmer; L Turco; M Mirzaie; E Mause; A Mause; A Person; S W Leslie; D L Cornell; M Wagner; R Bertellotti; J A Asensio Journal: Eur J Trauma Emerg Surg Date: 2017-07-20 Impact factor: 3.693
Authors: Ross E Anderson; Sorena Keihani; Rachel A Moses; Alexander P Nocera; J Patrick Selph; Clara M Castillejo Becerra; Nima Baradaran; Katie Glavin; Joshua A Broghammer; Chirag S Arya; Rachel L Sensenig; Michael E Rezaee; Bradley J Morris; Sarah Majercik; Timothy Hewitt; Frank N Burks; Ian Schwartz; Sean P Elliott; Xian Luo-Owen; Kaushik Mukherjee; Peter B Thomsen; Bradley A Erickson; Brandi D Miller; Richard A Santucci; LaDonna Allen; Scott Norwood; Cameron N Fick; Brian P Smith; Joshua Piotrowski; Christopher M Dodgion; Erik S DeSoucy; Scott Zakaluzny; Dennis Y Kim; Benjamin N Breyer; Barbara U Okafor; Reza Askari; Jacob W Lucas; Jay Simhan; Seyyed Saeed Khabiri; Raminder Nirula; Jeremy B Myers Journal: J Urol Date: 2020-04-07 Impact factor: 7.450