Citation

Jarvis S, Rudersdorf P, Poling J, Hennig A, Salottolo K, Bouchard T, Tanner A, Erickson W, Bhuller S, Ouderkirk L, Simpson J, Banton K, Kim E, Bar-Or D. Patient Saf. Surg. 2022; 16(1): e31.

Copyright

(Copyright © 2022, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s13037-022-00340-x

PMID

36109755

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.

Language: en

Keywords

Abdominal trauma; Altitude; Blunt trauma; Thoracic trauma; Traumatic aortic injuries