Vol.:(0123456789) 1 3 Pediatric Surgery International https://doi.org/10.1007/s00383-018-4417-z ORIGINAL ARTICLE Variability in the evalution of pediatric blunt abdominal trauma Adam M. Vogel 1  · Jingwen Zhang 2  · Patrick D. Mauldin 2  · Regan F. Williams 3  · Eunice Y. Huang 3  · Matthew T. Santore 4  · Kuojen Tsao 5  · Richard A. Falcone 6  · M. Sidney Dassinger 7  · Jefrey H. Haynes 8  · Martin L. Blakely 9  · Robert T. Russell 10  · Bindi J. Naik‑Mathuria 1  · Shawn D. St Peter 11  · David Mooney 12  · Jefrey S. Upperman 13  · Christian J. Streck 2 Accepted: 3 November 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Purpose To describe the practice pattern for routine laboratory and imaging assessment of children following blunt abdomi- nal trauma (BAT). Methods Children (age < 16 years) presenting to 14 pediatric trauma centers following BAT over a 1-year period were prospectively identifed. Injury, demographic, routine laboratory and imaging utilization data were collected. Descriptive, comparative, and correlation analysis was performed. Results 2188 children with a median age of 8 (4,12) years were included and the median injury severity score was 5 (1,10). There were signifcant diferences in activation status, injury severity, and mechanism across centers; however, there was no correlation of level of activation, injury severity, or severe mechanism with test utilization. Routine laboratory and imaging utilization for hematocrit, hepatic enzymes, pancreatic enzymes, base defcit urine microscopy, chest and pelvis X-ray, and abdominal computed tomography (CT) varied signifcantly among centers. Only obtaining a hematocrit had a moderate correlation with CT use. There was no correlation between centers that were high or low frequency laboratory utilizers with CT use. Conclusions Wide variability exists in the routine initial laboratory and imaging assessment in children following BAT. This represents an opportunity for quality improvement in pediatric trauma. Level of evidence Level II. Keywords Pediatric · Blunt abdominal trauma · Variability * Adam M. Vogel adamv@bcm.edu 1 Baylor College of Medicine, Texas Children’s Hospital, 6701 Fannin Street, Suite 1210, Houston, TX 77030, USA 2 Medical University of South Carolina, Charleston, SC, USA 3 University of Tennessee Health Science Center at Memphis, Memphis, TN, USA 4 Emory University School of Medicine, Atlanta, GA, USA 5 University of Texas Health Science Center at Houston, Houston, TX, USA 6 Cincinnati Children’s Hospital, Cincinnati, OH, USA 7 Arkansas Children’s Hospital, Little Rock, AR, USA 8 Virginia Commonwealth University, Richmond, VA, USA 9 Vanderbilt University School of Medicine, Nashville, TN, USA 10 University of Alabama Birmingham School of Medicine, Birmingham, AL, USA 11 Children’s Mercy Kansas City, Kansas City, MO, USA 12 Boston Children’s Hospital, Boston, MA, USA 13 Children’s Hospital Los Angeles, Los Angeles, CA, USA