Management of complex pediatric and adolescent liver trauma: adult vs pediatric level 1 trauma centers

Topic overview

Key takeaways

• Adult trauma centers used interventional radiology 10x more often than pediatric centers for high-grade liver injuries (51.9% vs 4.8%).
• Pediatric trauma centers successfully managed >95% of Grade 4/5 liver injuries non-operatively despite lower IR utilization.
• Adult trauma centers treated older patients with higher injury severity scores and more penetrating trauma compared to pediatric centers.
• Operative management rates were higher at adult centers (26.7% vs 11.0%), but mortality and length of stay were similar between center types.
• Optimal management algorithms for older adolescents with complex liver trauma remain unclear and require prospective study.

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