{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T21:56:49Z","timestamp":1784584609625,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T00:00:00Z","timestamp":1650672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although more guideline\u2010adherent care has been described in pediatric compared to adult trauma centers, we aimed to provide a more detailed characterization of management and resource utilization of children with intra\u2010abdominal injury (IAI) within pediatric centers. Our primary objective was to describe the epidemiology, diagnostic evaluation, and management of children with IAI across U.S. children's hospitals. Our secondary objective was to describe the interhospital variation in surgical management of children with IAI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cross\u2010sectional study of 33 hospitals in the Pediatric Health Information System. We included children aged &lt;18\u2009years evaluated in the emergency department from 2010 to 2019 with IAI, as defined by ICD coding, and who underwent an abdominal computed tomography (CT). Our primary outcome was abdominal surgery. We categorized IAI by organ system and described resource utilization data. We used generalized linear regression to calculate adjusted hospital\u2010level proportions of abdominal surgery, with a random effect for hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We studied 9265 children with IAI. Median (IQR) age was 9.0 (6.0\u201313.0)\u00a0years. Abdominal surgery was performed in 16% (<jats:italic>n<\/jats:italic>\u00a0=\u20091479) of children, with the lowest proportion of abdominal surgery observed in children aged &lt;5\u2009years. Liver (38.6%) and spleen (32.1%) were the most common organs injured. A total of 3.1% of children with liver injuries and 2.8% with splenic injuries underwent abdominal surgery. Although there was variation in rates of surgery across hospitals (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001), only three of 33 hospitals had rates that were statistically different from the aggregate mean of 16%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most children with IAI are managed nonoperatively, and most children's hospitals manage children with IAI similarly. These data can be used to inform future benchmarking efforts across hospitals to assess concordance with guidelines for the management of children with IAI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14497","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T05:40:45Z","timestamp":1649050845000},"page":"944-953","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Epidemiology and management of abdominal injuries in children"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7732-632X","authenticated-orcid":false,"given":"Pradip P.","family":"Chaudhari","sequence":"first","affiliation":[{"name":"Division of Emergency and Transport Medicine Children's Hospital Los Angeles and Keck School of Medicine of the University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Rodean","sequence":"additional","affiliation":[{"name":"Children's Hospital Association  Lenexa Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan G.","family":"Spurrier","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery Children's Hospital Los Angeles and Keck School of Medicine of the University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Hall","sequence":"additional","affiliation":[{"name":"Children's Hospital Association  Lenexa Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R.","family":"Marin","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics, Emergency Medicine, &amp; Radiology University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1389-5726","authenticated-orcid":false,"given":"Sriram","family":"Ramgopal","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Department of Pediatrics Ann &amp; Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Alpern","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Department of Pediatrics Ann &amp; Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir S.","family":"Shah","sequence":"additional","affiliation":[{"name":"Divisions of Hospital Medicine and Infectious Diseases, Department of Pediatrics Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2319-6192","authenticated-orcid":false,"given":"Stephen B.","family":"Freedman","sequence":"additional","affiliation":[{"name":"Sections of Pediatric Emergency Medicine and Gastroenterology, Departments of Pediatrics and Emergency Medicine, Alberta Children's Hospital, Alberta Children's Hospital Research Institute Cumming School of Medicine, University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Medicine and Child Health Evaluative Sciences, The Hospital for Sick Children and Department of Pediatrics and Institute of Health Policy, Management &amp; Evaluation The University of Toronto and ICES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rustin B.","family":"Morse","sequence":"additional","affiliation":[{"name":"Center for Clinical Excellence Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark I.","family":"Neuman","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine Boston Children's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.11.009"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.12.041"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2019.01.012"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000808"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(00)90003-4"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2015.08.012"},{"issue":"2","key":"e_1_2_9_8_1","first-page":"S114","article-title":"Disparities in the delivery of pediatric trauma care","volume":"67","author":"Petrosyan M","year":"2009","journal-title":"J Trauma"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2020.01.001"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002757"},{"issue":"2","key":"e_1_2_9_11_1","first-page":"S135","article-title":"Intra\u2010abdominal solid organ injury in children: diagnosis and treatment","volume":"67","author":"Gaines BA","year":"2009","journal-title":"J Trauma"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-018-4417-z"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001533"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000731"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00075198-199612000-00008"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/15389588.2016.1191069"},{"key":"e_1_2_9_17_1","volume-title":"Abbreviated Injury Scale (AIS) 2005 \u2010 update 2008","author":"The Association for the Advancement of Automotive Medicine (AAAM)","year":"2008"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2017-042519"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002581"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040297"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2016.08.004"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2017.06.004"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2005.10.012"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.01.041"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2008.02.031"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14497","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acem.14497","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14497","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T01:40:01Z","timestamp":1692754801000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.14497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,23]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1111\/acem.14497"],"URL":"https:\/\/doi.org\/10.1111\/acem.14497","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,23]]},"assertion":[{"value":"2022-03-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}