Long term complications of paediatric blunt abdominal trauma

• Research type

  Research Study

• Full title

  Long term complications of paediatric blunt abdominal and renal trauma. A multi-centre study.

• IRAS ID

  288723

• Contact name

  Adam Brooks

• Contact email

  adam.brooks@nuh.nhs.uk

• Sponsor organisation

  Nottingham University Hospitals NHS Trust

• Duration of Study in the UK

  1 years, 0 months, 1 days

• Research summary

  Research Summary

  While the immediate and short term complications of a Blunt Abdominal Trauma are well described in literature (peritonitis, haemorrhagic shock, and death), the long-term complications for different management strategies have not been so thoroughly investigated. Where evidence is available it is limited to single organs or solid organs only, and there is no consensus on follow up and hospital length of stay, particularly when non-operative management is used.
  Our aim is to provide data on the long term complications of paediatric BAT (including renal trauma) stratified according to operative and non-operative treatment. The study will provide an overview of the long-term organ functionality after Non Operative, Operative Management and Interventional Radiology procedures, useful for future reference and to plan a long term follow up based on the injuries’ gravity.

  Summary of Results

  The majority of paediatric Blunt Abdominal Trauma patients do not present any long-term complications (74%). The commonest complication is chronic abdominal pain, present in 8% of patients, followed by altered bowel habits (7%) and PTSD (6%). The median length of stay is very variable with no real difference between single organ injury and multi-organ injury groups.
  The incidence of post-traumatic stress disease following blunt abdominal trauma appears low overall but higher in the operative management group (19%) and statistically significant as per Fisher exact test.
  The results of our assessment the long-term functionality of the organs, both after non operative management and operative management, are non-significant as per Fisher exact test.
  This study confirms that long term complications following blunt abdominal trauma in children are not too frequent and mainly minor. There is a non-insignificant proportion of patients presenting with PTSD and there is no data on their follow up – further studies are needed in that direction and offering psychological support and follow up should be normal practice (either from the MTC or from GPs. Given the small sample obtained we are unable to draw conclusions on whether a different follow up strategy should be followed, but at present clinical follow up depends on injury severity and on the surgeon’s strategy while imaging follow up is reserved to symptomatic patients

• REC name

  West of Scotland REC 5

• REC reference

  21/WS/0024

• Date of REC Opinion

  5 Mar 2021

• REC opinion

  Further Information Favourable Opinion