揭示怀孕期间创伤的影响。

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-02-01 DOI:10.1016/j.amjsurg.2024.116124

Anna Mary Jose, Aryan Rafieezadeh, Jordan Kirsch, Mikaiel Ebanks, Ilya Shnaydman, Gabriel Froula, Kartik Prabhakaran, Bardiya Zangbar

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引用次数: 0

摘要

背景：怀孕创伤患者在评估和管理方面面临着独特的挑战。本研究利用国家创伤数据库评估创伤性损伤对怀孕患者的影响。方法：ACS-TQIP（2020-2021）对年龄≥15岁、≤55岁的女性外伤患者进行鉴定。倾向评分匹配比较怀孕和未怀孕的患者。主要结局是死亡率，次要结局包括住院时间（LOS）、急诊科和出院处理、干预措施和并发症。结果：947,000名女性外伤患者中，有8421人（0.9%）怀孕。孕妇火器伤发生率（6.0%）高于非孕妇火器伤发生率（5.4%）（p = 0.02）。与未怀孕患者相比，怀孕患者有更严重的胸部（47.2%vs. 9.4%）和腹部损伤（7.1%vs. 4.8%） (p结论：怀孕患者更容易成为枪支暴力的受害者，持续严重的胸部和腹部损伤。这些伤害需要更多的干预措施，引起并发症，并可能致命。

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Unveiling the impact of trauma during pregnancy

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.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.