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An Abdominal Seat Belt Sign is Associated With Similar Incidence of Hollow Viscus Injury but Increased In-Hospital Mortality in Older Adult Trauma Patients: A PCSA Multicenter Study.
Sullivan, Brittany G; Delaplain, Patrick T; Manasa, Morgan; Tay-Lasso, Erika; Biffl, Walter L; Schaffer, Kathryn B; Sundel, Margaret; Behdin, Samar; Ghneim, Mira; Costantini, Todd W; Santorelli, Jarrett E; Switzer, Emily; Schellenberg, Morgan; Keeley, Jessica A; Kim, Dennis Y; Wang, Andrew; Dhillon, Navpreet K; Patel, Deven; Campion, Eric M; Robinson, Caitlin K; Kartiko, Susan; Quintana, Megan T; Estroff, Jordan M; Kirby, Katharine A; Nahmias, Jeffry.
Afiliación
  • Sullivan BG; Division of Trauma, Burns, & Surgical Critical Care, University of California, Irvine, Orange, CA, USA.
  • Delaplain PT; Division of Trauma, Burns, & Surgical Critical Care, University of California, Irvine, Orange, CA, USA.
  • Manasa M; Division of Trauma, Burns, & Surgical Critical Care, University of California, Irvine, Orange, CA, USA.
  • Tay-Lasso E; Division of Trauma, Burns, & Surgical Critical Care, University of California, Irvine, Orange, CA, USA.
  • Biffl WL; Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA.
  • Schaffer KB; Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA.
  • Sundel M; Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
  • Behdin S; Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
  • Ghneim M; Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
  • Costantini TW; Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego School of Medicine, San Diego, CA, USA.
  • Santorelli JE; Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego School of Medicine, San Diego, CA, USA.
  • Switzer E; Division of Acute Care Surgery, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA.
  • Schellenberg M; Division of Acute Care Surgery, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA.
  • Keeley JA; Division of Trauma/Acute Care Surgery/Surgical Critical Care, Harbor-UCLA Medical Center, Torrance, CA, USA.
  • Kim DY; Division of Trauma/Acute Care Surgery/Surgical Critical Care, Harbor-UCLA Medical Center, Torrance, CA, USA.
  • Wang A; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Dhillon NK; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Patel D; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Campion EM; Department of Surgery, Denver Health Medical Center, Denver, CO, USA.
  • Robinson CK; Department of Surgery, Denver Health Medical Center, Denver, CO, USA.
  • Kartiko S; Department of Surgery, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
  • Quintana MT; Department of Surgery, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
  • Estroff JM; Department of Surgery, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
  • Kirby KA; Center for Statistical Consulting, Department of Statistics, University of California Irvine, Irvine, CA, USA.
  • Nahmias J; Division of Trauma, Burns, & Surgical Critical Care, University of California, Irvine, Orange, CA, USA.
Am Surg ; : 31348241256084, 2024 May 22.
Article en En | MEDLINE | ID: mdl-38775262
ABSTRACT

BACKGROUND:

The abdominal seat belt sign (SBS) is associated with an increased risk of hollow viscus injury (HVI). Older age is associated with worse outcomes in trauma patients. Thus, older trauma patients ≥65 years of age (OTPs) may be at an increased risk of HVI with abdominal SBS. Therefore, we hypothesized an increased incidence of HVI and mortality for OTPs vs younger trauma patients (YTPs) with abdominal SBS. STUDY

DESIGN:

This post hoc analysis of a multi-institutional, prospective, observational study (8/2020-10/2021) included patients >18 years old with an abdominal SBS who underwent abdominal computed tomography (CT) imaging. Older trauma patients were compared to YTPs (18-64 years old) with bivariate analyses.

RESULTS:

Of the 754 patients included in this study from nine level-1 trauma centers, there were 110 (14.6%) OTPs and 644 (85.4%) YTPs. Older trauma patients were older (mean 75.3 vs 35.8 years old, P < .01) and had a higher mean Injury Severity Score (10.8 vs 9.0, P = .02). However, YTPs had an increased abdominal abbreviated-injury scale score (2.01 vs 1.63, P = .02). On CT imaging, OTPs less commonly had intraabdominal free fluid (21.7% vs 11.9%, P = .02) despite a similar rate of abdominal soft tissue contusion (P > .05). Older trauma patients also had a statistically similar rate of HVI vs YTPs (5.5% vs 9.8%, P = .15). Despite this, OTPs had increased mortality (5.5% vs 1.1%, P < .01) and length of stay (LOS) (5.9 vs 4.9 days P < .01).

CONCLUSION:

Despite a similar rate of HVI, OTPs with an abdominal SBS had an increased rate of mortality and LOS. This suggests the need for heightened vigilance when caring for OTPs with abdominal SBS.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: Am Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: Am Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos