American journal of surgery · 2024
Unveiling the impact of trauma during pregnancy.
СтатьяНазвание и аннотация: Перевод в очереди
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Jose Anna Mary, Rafieezadeh Aryan, Kirsch Jordan, Ebanks Mikaiel, Shnaydman Ilya, Froula Gabriel, Prabhakaran Kartik, Zangbar Bardiya
Аннотация
BACKGROUND: Pregnant trauma patients present unique challenges in terms of assessment and management. This study assesses the impact of traumatic injuries on pregnant patients using a national trauma database.
METHODS: ACS-TQIP (2020-2021) identified traumatically injured females aged ≥15 and ≤ 55. Propensity score matching compared pregnant and not-pregnant patients. Primary outcome was mortality, with secondary outcomes including length of stay (LOS), emergency department and discharge disposition, interventions, and complications.
RESULTS: Of 947,000 traumatically injured females, 8421 (0.9 %) were pregnant. Pregnant patients (6.0 %) sustained firearm injuries more than not-pregnant patients (5.4 %) (p = 0.02). Pregnant patients had more severe thoracic (47.2%vs.9.4 %) and abdominal injuries (7.1%vs.4.8 %) compared to not-pregnant patients (p < 0.001). Among pregnant patients, 5.6 % had preterm labor, 2.6 % had cesarean sections, and 1.9 % had abortions. After matching, there was no significant difference in mortality between both groups (p = 0.40). Pregnant patients had longer ICU LOS (p < 0.05) and higher rates of unplanned return to ICU (p < 0.05).
CONCLUSIONS: Pregnant patients are more often victims of firearm violence, sustaining critical thoracic and abdominal injuries. These injuries demand increased interventions, introduce complications, and can be fatal.
METHODS: ACS-TQIP (2020-2021) identified traumatically injured females aged ≥15 and ≤ 55. Propensity score matching compared pregnant and not-pregnant patients. Primary outcome was mortality, with secondary outcomes including length of stay (LOS), emergency department and discharge disposition, interventions, and complications.
RESULTS: Of 947,000 traumatically injured females, 8421 (0.9 %) were pregnant. Pregnant patients (6.0 %) sustained firearm injuries more than not-pregnant patients (5.4 %) (p = 0.02). Pregnant patients had more severe thoracic (47.2%vs.9.4 %) and abdominal injuries (7.1%vs.4.8 %) compared to not-pregnant patients (p < 0.001). Among pregnant patients, 5.6 % had preterm labor, 2.6 % had cesarean sections, and 1.9 % had abortions. After matching, there was no significant difference in mortality between both groups (p = 0.40). Pregnant patients had longer ICU LOS (p < 0.05) and higher rates of unplanned return to ICU (p < 0.05).
CONCLUSIONS: Pregnant patients are more often victims of firearm violence, sustaining critical thoracic and abdominal injuries. These injuries demand increased interventions, introduce complications, and can be fatal.