Unveiling the impact of trauma during pregnancy

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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Abstract

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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揭示怀孕期间创伤的影响。

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。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.

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