THE ROLE OF GENDER IN BLUNT THORACIC AORTIC INJURIES.

IF 1.6 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE
Ilenia D'Alessio, Nicola Monzio-Compagnoni, Greta Salinetti, Joseph DuBose, Benjamin W Starnes, Elina Quiroga, Davide Benasconi, Mario D'Oria, Sandro Lepidi, Pierantonio Rimoldi, Valerio Stefano Tolva
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引用次数: 0

Abstract

Objectives: Blunt thoracic aortic injuries (BTAIs) are the second leading cause of death in polytrauma patients. The majority of BTAIs occurs in males in the fifth decade, thoracic endovascular aortic repair (TEVAR) is the gold standard for the treatment. The role of gender in the natural history of BTAIs and in perioperative outcomes is still not clear.

Methods: A retrospective multicenter cohort study was conducted using dataset of the Aortic Trauma Foundation (ATF) Global Registry. The primary outcome of this study was to determine if gender correlates with a different severity of the aortic injury. The secondary outcome was to determine if gender affects perioperative complications after TEVAR.

Results: Within a total of 942 patients enrolled from February 2016 to May 2022, 623 patients met the inclusion criteria. Seventy-seven percent were males (age 44.2±17.9 years). The BTAIs grades according to the Society for Vascular Surgery (SVS) classification was: 158 (25.4%) grade I, 89 (14.3%) grade II, 310 (49.8%) grade III and 66 (10.6%) grade IV. Males showed a higher probability to develop more severe aortic lesions compared to women (OR 1.500 CI95%; p=0.035). TEVAR was performed in 384 patients and results reveal a higher risk of intra and perioperative complications in women, despite no statistical significance was demonstrated (p >0.05).

Conclusions: Gender related differences in the natural history of BTAIs and in the outcomes of patients undergoing TEVAR are present. Females show a lower risk of developing more severe aortic injuries, but they seem to develop more intra and perioperative complications when treated with TEVAR.

性别在钝性胸主动脉损伤中的作用。
目的:钝性胸主动脉损伤(BTAIs)是多发伤患者死亡的第二大原因。大多数BTAIs发生在50岁左右的男性,胸血管内主动脉修复(TEVAR)是治疗的金标准。性别在BTAIs自然史和围手术期预后中的作用尚不清楚。方法:采用主动脉创伤基金会(ATF)全球注册数据库进行回顾性多中心队列研究。这项研究的主要结果是确定性别是否与主动脉损伤的不同严重程度相关。次要结果是确定性别是否影响TEVAR术后围手术期并发症。结果:2016年2月至2022年5月共入组942例患者,623例患者符合纳入标准。77%为男性(年龄44.2±17.9岁)。根据血管外科学会(SVS)的分类,BTAIs的等级为:I级158 (25.4%),II级89 (14.3%),III级310 (49.8%),IV级66(10.6%)。与女性相比,男性出现更严重主动脉病变的可能性更高(OR为1.500 CI95%; p=0.035)。384例患者行TEVAR,结果显示女性患者术中及围手术期并发症风险较高,但差异无统计学意义(p < 0.05)。结论:在btai的自然史和接受TEVAR的患者的结果中存在性别相关差异。女性患者出现更严重主动脉损伤的风险较低,但在接受TEVAR治疗时,她们似乎出现了更多的手术内和围手术期并发症。
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来源期刊
CiteScore
3.00
自引率
13.30%
发文量
603
审稿时长
50 days
期刊介绍: Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal: Clinical Research (reports of clinical series, new drug or medical device trials) Basic Science Research (new investigations, experimental work) Case Reports (reports on a limited series of patients) General Reviews (scholarly review of the existing literature on a relevant topic) Developments in Endovascular and Endoscopic Surgery Selected Techniques (technical maneuvers) Historical Notes (interesting vignettes from the early days of vascular surgery) Editorials/Correspondence
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