Mechanism and mortality of pediatric XXXX .

@entity1 @entity1514 @entity20736 @entity3511 @entity130
BACKGROUND: @entity130 are rare, but have a high mortality rate in @entity1 and  adolescents. We sought to investigate mechanisms of injury and predictors of survival. MATERIALS AND METHODS: The Kids' Inpatient Database (1997-2009) was used to identify cases of @entity1514 and @entity3511 (International Classification of Diseases, ninth Revision, Clinical Modification codes 901.0, 902.0) occurring in @entity1 aged <20  y. Bivariate and risk-adjusted multivariate analyses were used to reveal associated diagnoses and procedures and to identify predictors of in-hospital mortality, respectively. Cases were limited to emergent or urgent admissions. RESULTS: A total of 468 cases were identified. Survival was 65% overall, 63% for @entity1 and 68% for @entity1 . The most common mechanism of injury was motor vehicle-related (77%), followed by other penetrating @entity130 (10%) and @entity130 (8%). On multivariate modeling, @entity1 (odds ratio, 0.15 [95% confidence interval, 0.05, 0.45]) and Hispanic @entity1 (0.17 [0.05, 0.60]) had lower associated mortality versus @entity1 and Caucasians, respectively. Self-pay @entity1 (6.47 [1.94, 21.6]) had higher mortality versus privately insured @entity1 . @entity1 in the fourth income quartile had lower mortality versus all income quartile @entity1 . @entity1 admitted to urban nonteaching hospitals (0.15 [0.04, 0.59]) had lower mortality versus those admitted to urban teaching hospitals. @entity1 with @entity20736 (47.9 [12.3, 187]) or necessitating exploratory laparotomy (13.7 [2.06, 91.4]) had the highest associated mortality overall. Survival increased over the study period between 1997 and  2009. CONCLUSIONS: Motor vehicle-related @entity130 are the predominant mechanisms of @entity130 in the pediatric population. Gender, race, payer status, income quartile, and hospital type, along with associated procedures and diagnoses, are significant determinants of mortality on multivariate analysis.
