Analysis of non-obstetric vaginal and vulvar trauma: risk factors for operative intervention
| Autor: | Sahil Gambhir, Viktor Gabriel, Areg Grigorian, Cristobal Barrios, Sebastian D. Schubl, Victor Joe, Nicole P. Bernal, Jeffry Nahmias |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Wounds Penetrating Wounds Nonpenetrating Lower risk Logistic regression Vulva 03 medical and health sciences Injury Severity Score 0302 clinical medicine Risk Factors Intervention (counseling) Humans Medicine Vaginal trauma Aged business.industry Obstetrics Accidents Traffic Middle Aged Trauma risk Surgery medicine.anatomical_structure Rape 030220 oncology & carcinogenesis Concomitant Vagina Female 030211 gastroenterology & hepatology business |
| Zdroj: | Updates in Surgery. 71:735-740 |
| ISSN: | 2038-3312 2038-131X |
| DOI: | 10.1007/s13304-019-00679-4 |
| Popis: | Vaginal and vulvar trauma may occur accidentally or because of an act of violence. Due to its rarity, little is known about risk factors effecting need for operative intervention. We sought to perform a large descriptive analysis of adult non-obstetric vulvovaginal trauma (VVT) and elucidate risk factors for requiring operative intervention. A retrospective analysis of the National Trauma Data Bank was performed between 2007 and 2015. Patients ≥ 16 years old with vaginal or vulvar trauma were identified. Risk factors for surgical intervention were identified using a multivariable logistic regression analysis. From 2,040,235 female patients, 2445 ( 0.2%) were identified to have VVT with the majority being injury to the vagina (68.6%). In patients with injury to the vagina, age 65 (OR = 0.41, CI 0.26-0.62, p 0.001), Injury Severity Score 25 (OR = 0.66, CI 0.50-0.86, p = 0.01) and victims of rape (OR = 0.39, 95% CI 0.26-0.57, p 0.001) were less likely to require operative intervention. In patients with injury to the vulva, age 65 (OR = 0.45, CI 0.21-0.94, p = 0.02), victims of rape (OR = 0.26, CI 0.08-0.87, p = 0.01) and gunshot violence (OR = 0.10, CI 0.02-0.59, p = 0.02) were less likely to require operative intervention, but those with a concomitant injury to the vagina were more likely to require operative intervention (OR = 2.56, CI 1.63-4.03, p 0.001). Injuries to the vagina or vulva occur in 0.2% of traumas. Interestingly, in both vulvar and vaginal trauma, older age, and involvement in rape were associated with lower risk for operative intervention. A combined injury to the vagina and vulva increases the need for operative intervention. |
| Databáze: | OpenAIRE |
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