# The necessity of CT scans on pediatric carotid injury after blunt trauma – An analysis of the traumaregister DGU®

## TL;DR

This study analyzes pediatric carotid injuries after blunt trauma using a large trauma registry to identify risk factors and reduce unnecessary CT scans.

## Contribution

The study identifies risk factors for pediatric blunt carotid injury and emphasizes cautious diagnostic approaches to reduce radiation exposure.

## Key findings

- Pediatric blunt carotid injury has a prevalence of 0.6% and is associated with higher injury severity and mortality.
- Full-body CT scans are more common in BCI patients, highlighting the need for targeted diagnostic strategies.
- Risk factors include head trauma, neurological deficits, and pre-hospital hypotension.

## Abstract

Blunt carotid injuries (BCI) in pediatric trauma patients are rare. Using data from the TraumaRegister DGU®, this study aims to identify screening parameters and calculate the prevalence of pediatric BCI. By proposing potential risk factors for a BCI, this research seeks to reduce unnecessary radiation exposure in pediatric trauma cases. These findings may enhance understanding of pediatric BCI and highlight the necessity of cautious diagnostic approaches that balance clinical needs with radiation risks.

The TraumaRegister DGU® is a multicenter database established in 1993 to document the treatment of severely injured patients from initial injury to hospital discharge. Data are collected in four phases: demographics, injury patterns, treatments, and outcomes. Almost 700 hospitals, primarily from Germany, contribute to the registry annually. Statistical analysis was conducted using SPSS. For analysis, the dataset was divided into two groups: trauma patients diagnosed with BCI and trauma patients without BCI. The complete dataset from the TraumaRegister DGU® for 2006–2020 was screened for relevant cases. The dataset was limited to patients between 0 and 15 years old.

Out of 9070 severely injured pediatric trauma patients analysed, 50 cases of pediatric BCI were identified, representing a prevalence of 0.6%. Patients with BCI presented with higher injury severity scores (ISS), lower Glasgow Coma Scale (GCS) scores, and a greater prevalence of head injuries, as well as thoracic, abdominal, and extremity injuries. These patients also experienced higher in-hospital mortality rates (34%) and required more frequent blood transfusions. Full-body CT scans were more commonly performed in patients with BCI.

This study highlights the rarity and severity of BCI in pediatric trauma patients, with a prevalence of 0.6%. Significant risk factors for a BCI include high injury severity, head trauma, neurological deficits, and pre-hospital hypotension. The findings emphasise the importance of early diagnosis and targeted diagnostic strategies to balance the need for prompt intervention with reducing unnecessary radiation exposure.