Association Between Adrenal Hematoma and Mortality in Pediatric Multiple Blunt Traumas: An Autopsy Evaluation
Bibliographic record
Abstract
Adrenal hematoma is a common hidden catastrophic complication in pediatric victims of multiple blunt traumas. Adrenal hematoma has no obvious symptoms and may not be detected by diagnostic methods such as magnetic resonance imaging, computed tomography scan, and sonography; consequently, this complication may be neglected in children with multiple blunt traumas and cause death through sudden adrenal crisis. The current study was conducted on 55 dead children (<13 y) and 110 matured youths (13–17 y) who died in consequence of multiple blunt traumas, comprising car crashes, fall from heights, and falling debris. Our autopsy results showed that the overall prevalence of adrenal hematoma was 26% and this rate was higher in lower ages (1–6 y). There was no significant difference regarding the occurrence of adrenal hematoma between the genders. Adrenal hematoma was most common in abdominal and pelvic traumas. Peritoneal hemorrhage, liver damage, spleen rupture, omental injury, retroperitoneal hemorrhage, renal hematoma, and pelvic fracture were the most common complications associated with adrenal hematoma. In contrast to the previous studies, hematoma was mostly observed in the left adrenal. The incidence of damage to the pancreas, which similarly to the adrenal is a retroperitoneal organ, was very low (1.7%). The high incidence of adrenal hematoma due to severe abdominopelvic trauma in children warrants further research. Future studies should shed sufficient light on the efficacy of prophylactic steroids in patients with suspicion of severe abdominopelvic trauma.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".