Cardiac Evaluation of Children Presenting with Trauma

Abstract

Abstract Elevated plasma levels of cardiac troponin in polytrauma patients may be associated with the severity of injury and mortality. In this study, we aimed to determine the predictive value of troponin and the effect of cardiac evaluations on prognosis in pediatric patients admitted to the emergency department due to trauma. In the study, 97 patients aged 0-18 years who presented with trauma were included. The cause and severity of the trauma, electrocardiography and echocardiography results, and laboratory data (biochemical, hemogram, C-reactive protein, pro-BNP, CK-MB, troponin, etc.) of the patients were evaluated. Falling from height was the most common cause of injury (43%). In 55 (56%) patients, chest trauma was found. Troponin elevation was present in all patients with chest trauma. Troponin levels were found to be statistically significantly higher in patients with chest trauma compared to those who did not have chest trauma (p=0.011). While the mean Sequential Organ Failure Assessment Score (SOFA) of the patients who were discharged was 4.94±2.58, the mean SOFA score of the patients who died was found to be statistically higher with 10.78±1.39 (≤0.01). Our findings have revealed the prognostic value of cardiac troponins in terms of direct or indirect injury to the heart, especially in pediatric patients with chest trauma. Therefore, in children presenting with chest trauma, determining the cardiac injury by evaluating the electrocardiography results, which can be easily accessed in every health center, and cardiac troponins may be a guide in terms of patient prognosis.