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Outcomes of severely injured pregnant trauma patients: a multicenter analysis.

Authors :
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
Source :
Updates in Surgery; Oct2024, Vol. 76 Issue 6, p2441-2447, 7p
Publication Year :
2024

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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
2038131X
Volume :
76
Issue :
6
Database :
Complementary Index
Journal :
Updates in Surgery
Publication Type :
Academic Journal
Accession number :
180735490
Full Text :
https://doi.org/10.1007/s13304-024-01817-3