Thoracolumbar Injury Classification and Severity Scale Can Help Identify Intra-Abdominal Injury in Children Injured in an MVC

Background: Motor vehicle crashes (MVC) cause variable injury to the thoracolumbar (TL) region of children secondary rapid deceleration from seatbelts. This mechanism can also predispose a child intraabdominal (IAI), which necessitates early diagnosis limit morbidity and mortality. While maximum extent TL-spine be appreciated shortly after presentation, severity IAI may not until days later. It is hypothesized that measure TL-injury will identify patients at risk concomitant IAI. Methods: Retrospective chart review identified 72 with MVC-related injuries 2007-2020. Patients were grouped based on presence (N=33) compared isolated (no IAI, N=39). was classified according Thoracolumbar Injury Classification Severity Scale (TLICS). Results: Demographics similar in both groups. Children had primarily lumbar spine injuries, while without associated more broadly distributed throughout spine. likely sustain compression fractures (n=31, 79%), distraction (n=24, 73%). TL significantly severe than injures (median TLICS=7 [range: 1-9] vs 1 1-10], p<0.001). As hypothesized, increasing TLICS an increased such for every point increase TLICS, increases 49% (OR: 1.492, [95% CI 1.254-1.817], AROC 0.795) Conclusions: Given close association between this study illustrates utility score presentation establish high index suspicion other clinical signs suggestive our provides clinicians new datapoint, as graded by (i.e., >5), their diagnostic toolbox optimally manage pediatric MVC.