Characteristics of Trauma Mortality in Patients with Aortic Injury in Harris County, Texas
Abstract
:1. Introduction
2. Methods
3. Results
3.1. Demographics and Death Characteristics
3.2. Anatomic Description of Aortic Injuries
3.3. Subgroup Analysis of PP Deaths
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Non-Preventable (n = 178) | Potentially Preventable (n = 14) | p | |
---|---|---|---|
Age (y) | 37 (24, 52) | 43 (27, 56) | 0.36 |
Blunt mechanism (n, %) | 123 (69%) | 1 (7%) | <0.01 |
Death location (n, %) | |||
Scene | 149 (84%) | 7 (50%) | <0.01 * |
Level 1 trauma ctr | 14 (8%) | 3 (21%) | |
ED | 9 (64%) | 0 (0%) | |
ICU | 2 (14%) | 2 (14%) | |
OR | 3 (22%) | 1 (7%) | |
Level 3 trauma ctr † | 12 (7%) | 4 (29%) | |
Level 4 trauma ctr † | 1 (<1%) | 0 (0%) | |
Non-trauma ctr † | 2 (1%) | 0 (0%) | |
Time from EMS notified to death (min) | 0 (0, 10) | 18 (0, 91) | <0.05 |
Reason for death (n, %) ‡ | |||
Hemorrhage | 129 (72%) | 12 (86%) | 0.36 |
TBI | 97 (54%) | 2 (14%) | <0.01 |
Non-Preventable (n = 178) | Potentially Preventable (n = 14) | |
---|---|---|
Zone 0 | 46 (26%) | 1 (7%) |
Zone 1 | 4 (2%) | 0 (0%) |
Zone 2 | 8 (4%) | 0 (0%) |
Zone 3 | 29 (16%) | 0 (0%) |
Zone 4 | 58 (33%) | 1 (7%) |
Zone 5 | 38 (21%) | 3 (21%) |
Zone 6 | 7 (4%) | 1 (7%) |
Zone 7 | 2 (1%) | 0 (0%) |
Zone 8 | 4 (2%) | 2 (14%) |
Zone 9 | 6 (3%) | 8 (57%) |
Multiple injuries | 24 (13%) | 2 (14%) |
Non-Preventable (n = 178) | Potentially Preventable (n = 14) | p | |
---|---|---|---|
Thoracic | 166 (93%) | 5 (36%) | <0.01 |
Arch | 58 (33%) | 1 (7%) | |
Descending | 140 (79%) | 4 (29%) | |
Abdominal | 22 (37%) | 11 (79%) | <0.01 |
Visceral | 15 (8%) | 4 (29%) | |
Infrarenal | 12 (7%) | 9 (64%) | |
Multiple regions | 42 (24%) | 4 (29%) | 1.00 |
Patient | Zone of Aortic Injury | Injury Mechanism | Cause of Death |
---|---|---|---|
Patient 1 | 5, 9 | Motorcycle collision | TBI |
Patient 2 | 6, 7 | GSW | Hemorrhage |
Patient 3 | 8, 9 | GSW | Hemorrhage |
Patient 4 | 5 | GSW | Hemorrhage |
Patient 5 | 9 | GSW | Hemorrhage |
Patient 6 | 8 | GSW | Hemorrhage |
Patient 7 | 5 to 8 | GSW | Hemorrhage and TBI |
Patient | Zone of Aortic Injury | Location of Death | ISS | Prehospital Interventions | Distance from Scene to Nearest Level 1 Trauma Center (Miles) | Ed SBP | Additional Ed Interventions | Time from Ems Notified to Ed Arrival (min) | Time from Ed Arrival to Death (min) |
---|---|---|---|---|---|---|---|---|---|
Patient 8 | 9 | Level 3 trauma center ED | Unknown | CPR, laryngeal airway | 20.2 | 0 | None | 59 | 2 |
Patient 9 | 9 | Level 3 trauma center ED | 29 | CPR, intubation | 16.3 | 0 | Chest tube, blood products, resuscitative thoracotomy | 24 | 23 |
Patient 10 | 9 | Level 3 trauma center ED | 16 | CPR, intubation | 17.3 | 0 | None | 39 | 1 |
Patient 11 | 0 | Level 3 trauma center ED | 26 | CPR, intubation, needle chest thoracostomy | 12.3 | 0 | None | 23 | 12 |
Patient 12 | 4, 9 | Level 1 trauma center OR | 75 | CPR | 17.6 | 0 | Intubation, blood products, resuscitative thoracotomy | 31 | 60 |
Patient 13 | 9 | Level 1 trauma center ICU | 50 | CPR | 7.8 | 0 | Intubation, blood products, resuscitative thoracotomy | 38 | 511 |
Patient 14 | 9 | Level 1 trauma center ICU | 26 | None | 12 | 82 | CPR, Intubation, blood products, resuscitative thoracotomy | 20 | 437 |
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Chang, R.; Drake, S.A.; Holcomb, J.B.; Phillips, G.; Wade, C.E.; Charlton-Ouw, K.M. Characteristics of Trauma Mortality in Patients with Aortic Injury in Harris County, Texas. J. Clin. Med. 2020, 9, 2965. https://doi.org/10.3390/jcm9092965
Chang R, Drake SA, Holcomb JB, Phillips G, Wade CE, Charlton-Ouw KM. Characteristics of Trauma Mortality in Patients with Aortic Injury in Harris County, Texas. Journal of Clinical Medicine. 2020; 9(9):2965. https://doi.org/10.3390/jcm9092965
Chicago/Turabian StyleChang, Ronald, Stacy A. Drake, John B. Holcomb, Garrett Phillips, Charles E. Wade, and Kristofer M. Charlton-Ouw. 2020. "Characteristics of Trauma Mortality in Patients with Aortic Injury in Harris County, Texas" Journal of Clinical Medicine 9, no. 9: 2965. https://doi.org/10.3390/jcm9092965
APA StyleChang, R., Drake, S. A., Holcomb, J. B., Phillips, G., Wade, C. E., & Charlton-Ouw, K. M. (2020). Characteristics of Trauma Mortality in Patients with Aortic Injury in Harris County, Texas. Journal of Clinical Medicine, 9(9), 2965. https://doi.org/10.3390/jcm9092965