Does altitude increase the risk of traumatic aortic injuries? A retrospective cohort study among six level I trauma centers in the United States.

Autor: Jarvis S; Injury Outcomes Network (ION) Research, 501 East Hampden Ave, Englewood, CO, 80113, USA., Rudersdorf P; Saint Anthony Hospital, 11600 West 2nd Place, Lakewood, CO, USA., Poling J; Saint Anthony Hospital, 11600 West 2nd Place, Lakewood, CO, USA., Hennig A; Saint Anthony Hospital, 11600 West 2nd Place, Lakewood, CO, USA., Salottolo K; Injury Outcomes Network (ION) Research, 501 East Hampden Ave, Englewood, CO, 80113, USA., Bouchard T; Swedish Medical Center, 501 East Hampden Ave, Englewood, CO, USA., Tanner A; Penrose Hospital, 2222 N. Nevada Ave, Colorado Springs, CO, USA., Erickson W; Penrose Hospital, 2222 N. Nevada Ave, Colorado Springs, CO, USA., Bhuller S; Research Medical Center, 2316 East Meyer Blvd, Kansas City, MO, USA., Ouderkirk L; Wesley Medical Center, 550 N Hillside St, Wichita, KS, USA., Simpson J; Research Medical Center, 2316 East Meyer Blvd, Kansas City, MO, USA., Banton K; Swedish Medical Center, 501 East Hampden Ave, Englewood, CO, USA., Kim E; Medical City Plano, 3901 West 15th Street, Plano, TX, USA., Bar-Or D; Injury Outcomes Network (ION) Research, 501 East Hampden Ave, Englewood, CO, 80113, USA. davidbme49@gmail.com.
Jazyk: angličtina
Zdroj: Patient safety in surgery [Patient Saf Surg] 2022 Sep 15; Vol. 16 (1), pp. 31. Date of Electronic Publication: 2022 Sep 15.
DOI: 10.1186/s13037-022-00340-x
Abstrakt: Background: Traumatic aortic injuries (TAIs) are rare but are associated with a high mortality. Prior studies have shown skiers and pilots, whose injuries occur at high altitudes, are at an increased risk for a TAI. The purpose of this study was to examine the effect of altitude on the incidence of TAIs across all causes of injury.
Methods: This retrospective cohort study at six Level I trauma centers (8/1/2016-1/1/2020) included adult blunt trauma patients with a chest or abdomen injury. High altitude injuries (> 5000 ft.) were compared to low altitude injuries (≤ 5000 ft.). The primary outcome was incidence of TAI.
Results: There were 8562 patients, 37% were at high altitude and 63% at low altitude. High altitude patients were older (p < 0.01), more often Caucasian (p < 0.01) and had a higher ISS (p < 0.01). There was a significantly greater incidence of TAI at high altitude than low altitude (1.5% vs. 1.1%, p = 0.01). The median altitude was significantly higher for patients with a TAI than for patients without a TAI (5100 ft. vs. 1400 ft., p = 0.01). After adjustment, high altitude patients had 2-fold [OR: 2.4 (1.6, 3.7)] greater odds of having a TAI than low altitude patients.
Conclusion: TAIs were more prevalent among high altitude injuries. Providers should be aware of the increased incidence of TAIs at high altitudes particularly when there is a delay in diagnosis and transfer to a trauma center with appropriate resources to manage these critical injuries. TAI screening at high altitude trauma centers may improve survival rates.
(© 2022. The Author(s).)
Databáze: MEDLINE
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