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Outcomes of severely injured pregnant trauma patients: a multicenter analysis.
Awad, Kyrillos G; Nahmias, Jeffry; Aryan, Negaar; Lucas, Alexa N; Fierro, Nicole; Dhillon, Navpreet K; Ley, Eric J; Smith, Jennifer; Burruss, Sigrid; Dahan, Alden; Johnson, Arianne; Ganske, William; Biffl, Walter L; Bayat, Dunya; Castelo, Matthew; Wintz, Diane; Schaffer, Kathryn B; Zheng, Dennis J; Tillou, Areti; Coimbra, Raul; Tuli, Rahul; Santorelli, Jarrett E; Emigh, Brent; Schellenberg, Morgan; Inaba, Kenji; Duncan, Thomas K; Diaz, Graal; Tay-Lasso, Erika; Zezoff, Danielle C; Grigorian, Areg.
Afiliación
  • Awad KG; Department of Surgery, Desert Regional Medical Center, Palm Springs, CA, USA.
  • Nahmias J; Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
  • Aryan N; Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
  • Lucas AN; Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
  • Fierro N; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Dhillon NK; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Ley EJ; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Smith J; Division of Trauma and Critical Care, Harbor-UCLA Hospital, Torrance, CA, USA.
  • Burruss S; Division of Trauma and Critical Care, Harbor-UCLA Hospital, Torrance, CA, USA.
  • Dahan A; Department of Trauma, Acute Care Surgery, Surgical Critical Care, Loma Linda Medical Center, Loma Linda, CA, USA.
  • Johnson A; Cottage Health Research Institute, Santa Barbara Cottage Hospital, Santa Barbara, CA, USA.
  • Ganske W; Cottage Health Research Institute, Santa Barbara Cottage Hospital, Santa Barbara, CA, USA.
  • Biffl WL; Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA.
  • Bayat D; Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA.
  • Castelo M; Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA.
  • Wintz D; Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA.
  • Schaffer KB; Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA.
  • Zheng DJ; Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
  • Tillou A; Riverside University Health System Medical Center, Comparative Effectiveness and Clinical Outcomes Research Center - CECORC, Moreno Valley, CA, USA.
  • Coimbra R; Riverside University Health System Medical Center, Comparative Effectiveness and Clinical Outcomes Research Center - CECORC, Moreno Valley, CA, USA.
  • Tuli R; Riverside University Health System Medical Center, Comparative Effectiveness and Clinical Outcomes Research Center - CECORC, Moreno Valley, CA, USA.
  • Santorelli JE; Division of Trauma, Surgical Critical Care, Burns, and Acute Care Surgery, San Diego School of Medicine, University of California, San Diego, CA, USA.
  • Emigh B; The Warren Alpert Medical School of Brown University, Providence, RI, USA.
  • Schellenberg M; Division of Acute Care Surgery, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA.
  • Inaba K; Division of Acute Care Surgery, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA.
  • Duncan TK; Department of Trauma, Ventura County Medical Center, Ventura, CA, USA.
  • Diaz G; Department of Trauma, Ventura County Medical Center, Ventura, CA, USA.
  • Tay-Lasso E; Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
  • Zezoff DC; Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
  • Grigorian A; Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA. agrigori@uci.edu.
Updates Surg ; 2024 Mar 30.
Article en En | MEDLINE | ID: mdl-38554224
ABSTRACT
Nearly 10% of pregnant women suffer traumatic injury. Clinical outcomes for pregnant trauma patients (PTPs) with severe injuries have not been well studied. We sought to describe outcomes for PTPs presenting with severe injuries, hypothesizing that PTPs with severe injuries will have higher rates of complications and mortality compared to less injured PTPs. A post-hoc analysis of a multi-institutional retrospective study at 12 Level-I/II trauma centers was performed. Patients were stratified into severely injured (injury severity score [ISS] > 15) and not severely injured (ISS < 15) and compared with bivariate analyses. From 950 patients, 32 (3.4%) had severe injuries. Compared to non-severely injured PTPs, severely injured PTPs were of similar maternal age but had younger gestational age (21 vs 26 weeks, p = 0.009). Penetrating trauma was more common in the severely injured cohort (15.6% vs 1.4%, p < 0.001). The severely injured cohort more often underwent an operation (68.8% vs 3.8%, p < 0.001), including a hysterectomy (6.3% vs 0.3%, p < 0.001). The severely injured group had higher rates of complications (34.4% vs 0.9%, p < 0.001), mortality (15.6% vs 0.1%, p < 0.001), a higher rate of fetal delivery (37.5% vs. 6.0%, p < 0.001) and resuscitative hysterotomy (9.4% vs. 0%, p < 0.001). Only approximately 3% of PTPs were severely injured. However, severely injured PTPs had a nearly 40% rate of fetal delivery as well as increased complications and mortality. This included a resuscitative hysterotomy rate of nearly 10%. Significant vigilance must remain when caring for this population.
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Texto completo: 1 Bases de datos: MEDLINE Idioma: En Revista: Updates Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Bases de datos: MEDLINE Idioma: En Revista: Updates Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos