Chapter 14
Pediatric Thoracic Trauma
Silfrance Tran, MD
Anthony C. Chin, MDI. INTRODUCTION
Trauma is the leading cause of death in children between the ages of 1
and 14 years in the United States. In 2012, according to the National Trauma
Database Registry, 12% of pediatric trauma patients suffered injury to the
chest. Although chest trauma is less common in children, it remains an area of
concern because it is associated with increased mortality. In fact, chest trauma
accounts for up to 14% of trauma-related deaths in the pediatric population,
making it second only to blunt head injuries. Children with isolated chest
injuries have a mortality of approximately 5%. However, in cases where there is
multi-system involvement concomitant with thoracic injuries, such as abdominal
or brain injury, mortality drastically increases to nearly 40% to 70%.
Blunt force injury is the most common cause of thoracic trauma in
children. Among these cases, 77% are due to motor vehicle accidents. This
makes motor vehicle crashes the number one mechanism of traumatic chest
injury in the pediatric population overall. Children are either passengers in
traffic accidents or pedestrians struck by motor vehicles. The next most
common cause of blunt thoracic injury is falls. Other less frequent causes
include child abuse, high-risk sporting activities, violence, or suicide.