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- Title
Does altitude increase the risk of traumatic aortic injuries? A retrospective cohort study among six level I trauma centers in the United States.
- Authors
Jarvis, Stephanie; Rudersdorf, Patrick; Poling, James; Hennig, Andreas; Salottolo, Kristin; Bouchard, Travis; Tanner, Allen; Erickson, Wendy; Bhuller, Sidra; Ouderkirk, Logan; Simpson, Jeffrey; Banton, Kaysie; Kim, Elizabeth; Bar-Or, David
- Abstract
Background: Traumatic aortic injuries (TAIs) are rare but are associated with a high mortality. Prior studies have shown skiers and pilots, whose injuries occur at high altitudes, are at an increased risk for a TAI. The purpose of this study was to examine the effect of altitude on the incidence of TAIs across all causes of injury. Methods: This retrospective cohort study at six Level I trauma centers (8/1/2016–1/1/2020) included adult blunt trauma patients with a chest or abdomen injury. High altitude injuries (> 5000 ft.) were compared to low altitude injuries (≤ 5000 ft.). The primary outcome was incidence of TAI. Results: There were 8562 patients, 37% were at high altitude and 63% at low altitude. High altitude patients were older (p < 0.01), more often Caucasian (p < 0.01) and had a higher ISS (p < 0.01). There was a significantly greater incidence of TAI at high altitude than low altitude (1.5% vs. 1.1%, p = 0.01). The median altitude was significantly higher for patients with a TAI than for patients without a TAI (5100 ft. vs. 1400 ft., p = 0.01). After adjustment, high altitude patients had 2-fold [OR: 2.4 (1.6, 3.7)] greater odds of having a TAI than low altitude patients. Conclusion: TAIs were more prevalent among high altitude injuries. Providers should be aware of the increased incidence of TAIs at high altitudes particularly when there is a delay in diagnosis and transfer to a trauma center with appropriate resources to manage these critical injuries. TAI screening at high altitude trauma centers may improve survival rates.
- Subjects
UNITED States; AORTA injuries; BLUNT trauma; TRAUMA centers; RETROSPECTIVE studies; PATIENTS; CHEST injuries; MANN Whitney U Test; FISHER exact test; RISK assessment; T-test (Statistics); DISEASE prevalence; EMERGENCY medical services; CHI-squared test; WOUNDS &; injuries; ABDOMINAL injuries; ODDS ratio; LOGISTIC regression analysis; DATA analysis software; ALTITUDES; LONGITUDINAL method
- Publication
Patient Safety in Surgery, 2022, Vol 16, Issue 1, p1
- ISSN
1754-9493
- Publication type
Article
- DOI
10.1186/s13037-022-00340-x