Nonoperative management of many pediatric injuries has generated debate as to whether surgeons must be routinely involved in the early assessment and management of pediatric trauma
. This study examines the frequency of operative intervention among injured children and evaluates potential predictors of emergent
Pediatric (age < 18 years) patients were identified from the National Trauma Data Bank. Primary outcome measures were surgical intervention
by specialty, time to intervention, and mortality. Prehospital factors were evaluated as predictors of emergent surgical intervention
Thirty percent of trauma admissions underwent operative intervention, with 57% of these requiring emergent
surgery. Patients needing emergent
general or neurosurgical intervention were at increased risk of death. Requiring one type of emergent surgical intervention
was predictive of needing a second type of emergent
procedure. Predictors of emergent
general surgical intervention
were penetrating mechanism, increasing age, and the presence of shock or coma.
These data support the continued routine involvement of surgeons in the initial assessment and management of the injured child.