Pediatric Surgery International

, Volume 35, Issue 4, pp 479–485 | Cite as

Variability in the evalution of pediatric blunt abdominal trauma

  • Adam M. VogelEmail author
  • Jingwen Zhang
  • Patrick D. Mauldin
  • Regan F. Williams
  • Eunice Y. Huang
  • Matthew T. Santore
  • Kuojen Tsao
  • Richard A. Falcone
  • M. Sidney Dassinger
  • Jeffrey H. Haynes
  • Martin L. Blakely
  • Robert T. Russell
  • Bindi J. Naik-Mathuria
  • Shawn D. St Peter
  • David Mooney
  • Jeffrey S. Upperman
  • Christian J. Streck
Original Article



To describe the practice pattern for routine laboratory and imaging assessment of children following blunt abdominal trauma (BAT).


Children (age < 16 years) presenting to 14 pediatric trauma centers following BAT over a 1-year period were prospectively identified. Injury, demographic, routine laboratory and imaging utilization data were collected. Descriptive, comparative, and correlation analysis was performed.


2188 children with a median age of 8 (4,12) years were included and the median injury severity score was 5 (1,10). There were significant differences in activation status, injury severity, and mechanism across centers; however, there was no correlation of level of activation, injury severity, or severe mechanism with test utilization. Routine laboratory and imaging utilization for hematocrit, hepatic enzymes, pancreatic enzymes, base deficit urine microscopy, chest and pelvis X-ray, and abdominal computed tomography (CT) varied significantly among centers. Only obtaining a hematocrit had a moderate correlation with CT use. There was no correlation between centers that were high or low frequency laboratory utilizers with CT use.


Wide variability exists in the routine initial laboratory and imaging assessment in children following BAT. This represents an opportunity for quality improvement in pediatric trauma.

Level of evidence

Level II.


Pediatric Blunt abdominal trauma Variability 


Author contributions

Study conception and design: CJS, AMV, JZ, EYH, MSD, RTR, MLB. Acquisition of data: AMV, RFW, EYH, MTS, KT, RAF, MSD, JHH, MLB, RTR, BJN-M, SDSP, DM, JSU, CJS. Analysis and interpretation of data: CJS, AMV, JZ, PDM. Drafting of manuscript: CJS, AMV. Critical revision of the Manuscript: AMV, RFW, EYH, MTS, KT, RAF, MSD, JHH, MLB, RTR, BJN-M, SDSP, DM, JSU, CJS.


This study did not receive funding.

Compliance with ethical standards

Conflict of interest

Adam M. Vogel, MD declares that he has no conflict of interest. Jingwen Zhang, MS declares that he has no conflict of interest. Patrick D. Mauldin, PhD declares that he has no conflict of interest. Regan F. Williams, MD declares that she has no conflict of interest. Eunice Y. Huang, MD, MS declares that she has no conflict of interest. Matthew T. Santore, MD declares that he has no conflict of interest. Kuojen Tsao, MD declares that he has no conflict of interest. Richard A. Falcone, MD, MPH declares that he has no conflict of interest. M Sidney Dassinger, MD declares that he has no conflict of interest. Jeffrey H. Haynes, MD declares that he has no conflict of interest. Martin L. Blakely, MD, MS declares that he has no conflict of interest. Robert T. Russell, MD, MPH declares that he has no conflict of interest. Bindi J. Naik-Mathuria, MD, MPH declares that she has no conflict of interest. Shawn D. St Peter, MD declares that he has no conflict of interest. David Mooney, MD, MPH declares that he has no conflict of interest. Jeffrey S. Upperman, MD declares that he has no conflict of interest. Christian J. Streck, MD declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. IRB approval was obtained at each participating institution.

Informed consent

As a prospective, observational study, the study was deemed minimal risk and the need for informed consent was waived by participating center IRBs.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Adam M. Vogel
    • 1
    Email author
  • Jingwen Zhang
    • 2
  • Patrick D. Mauldin
    • 2
  • Regan F. Williams
    • 3
  • Eunice Y. Huang
    • 3
  • Matthew T. Santore
    • 4
  • Kuojen Tsao
    • 5
  • Richard A. Falcone
    • 6
  • M. Sidney Dassinger
    • 7
  • Jeffrey H. Haynes
    • 8
  • Martin L. Blakely
    • 9
  • Robert T. Russell
    • 10
  • Bindi J. Naik-Mathuria
    • 1
  • Shawn D. St Peter
    • 11
  • David Mooney
    • 12
  • Jeffrey S. Upperman
    • 13
  • Christian J. Streck
    • 2
  1. 1.Baylor College of MedicineTexas Children’s HospitalHoustonUSA
  2. 2.Medical University of South CarolinaCharlestonUSA
  3. 3.University of Tennessee Health Science Center at MemphisMemphisUSA
  4. 4.Emory University School of MedicineAtlantaUSA
  5. 5.University of Texas Health Science Center at HoustonHoustonUSA
  6. 6.Cincinnati Children’s HospitalCincinnatiUSA
  7. 7.Arkansas Children’s HospitalLittle RockUSA
  8. 8.Virginia Commonwealth UniversityRichmondUSA
  9. 9.Vanderbilt University School of MedicineNashvilleUSA
  10. 10.University of Alabama Birmingham School of MedicineBirminghamUSA
  11. 11.Children’s Mercy Kansas CityKansas CityUSA
  12. 12.Boston Children’s HospitalBostonUSA
  13. 13.Children’s Hospital Los AngelesLos AngelesUSA

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