An Abdominal Seat Belt Sign is Associated With Similar Incidence of Hollow Viscus Injury but Increased In-Hospital Mortality in Older Adult Trauma Patients: A PCSA Multicenter Study-Reference-Cited by-同舟云学术

An Abdominal Seat Belt Sign is Associated With Similar Incidence of Hollow Viscus Injury but Increased In-Hospital Mortality in Older Adult Trauma Patients: A PCSA Multicenter Study

Published:2024-05-22 Issue: Volume: Page:
ISSN:0003-1348
Container-title:The American Surgeon™
language:en
Short-container-title:The American Surgeon™

Author:

Sullivan Brittany G.¹,Delaplain Patrick T.¹,Manasa Morgan¹^ORCID,Tay-Lasso Erika¹,Biffl Walter L.²,Schaffer Kathryn B.²^ORCID,Sundel Margaret³,Behdin Samar³,Ghneim Mira³,Costantini Todd W.⁴,Santorelli Jarrett E.⁴,Switzer Emily⁵,Schellenberg Morgan⁵,Keeley Jessica A.⁶,Kim Dennis Y.⁶,Wang Andrew⁷,Dhillon Navpreet K.⁷,Patel Deven⁷,Campion Eric M.⁸,Robinson Caitlin K.⁸,Kartiko Susan⁹,Quintana Megan T.⁹,Estroff Jordan M.⁹,Kirby Katharine A.¹⁰,Nahmias Jeffry¹

Affiliation:

1. Division of Trauma, Burns, & Surgical Critical Care, University of California, Irvine, Orange, CA, USA

2. Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA

3. Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA

4. Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego School of Medicine, San Diego, CA, USA

5. Division of Acute Care Surgery, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA

6. Division of Trauma/Acute Care Surgery/Surgical Critical Care, Harbor-UCLA Medical Center, Torrance, CA, USA

7. Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA

8. Department of Surgery, Denver Health Medical Center, Denver, CO, USA

9. Department of Surgery, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA

10. Center for Statistical Consulting, Department of Statistics, University of California Irvine, Irvine, CA, USA

Abstract

Background The abdominal seat belt sign (SBS) is associated with an increased risk of hollow viscus injury (HVI). Older age is associated with worse outcomes in trauma patients. Thus, older trauma patients ≥65 years of age (OTPs) may be at an increased risk of HVI with abdominal SBS. Therefore, we hypothesized an increased incidence of HVI and mortality for OTPs vs younger trauma patients (YTPs) with abdominal SBS. Study Design This post hoc analysis of a multi-institutional, prospective, observational study (8/2020-10/2021) included patients >18 years old with an abdominal SBS who underwent abdominal computed tomography (CT) imaging. Older trauma patients were compared to YTPs (18-64 years old) with bivariate analyses. Results Of the 754 patients included in this study from nine level-1 trauma centers, there were 110 (14.6%) OTPs and 644 (85.4%) YTPs. Older trauma patients were older (mean 75.3 vs 35.8 years old, P < .01) and had a higher mean Injury Severity Score (10.8 vs 9.0, P = .02). However, YTPs had an increased abdominal abbreviated-injury scale score (2.01 vs 1.63, P = .02). On CT imaging, OTPs less commonly had intraabdominal free fluid (21.7% vs 11.9%, P = .02) despite a similar rate of abdominal soft tissue contusion ( P > .05). Older trauma patients also had a statistically similar rate of HVI vs YTPs (5.5% vs 9.8%, P = .15). Despite this, OTPs had increased mortality (5.5% vs 1.1%, P < .01) and length of stay (LOS) (5.9 vs 4.9 days P < .01). Conclusion Despite a similar rate of HVI, OTPs with an abdominal SBS had an increased rate of mortality and LOS. This suggests the need for heightened vigilance when caring for OTPs with abdominal SBS.

Publisher

SAGE Publications

Link

https://journals.sagepub.com/doi/pdf/10.1177/00031348241256084

Reference21 articles.

1. The “Seat Belt Mark” Sign: A Call for Increased Vigilance among Physicians Treating Victims of Motor Vehicle Accidents

2. The “Seat Belt Mark” Sign: A Call for Increased Vigilance among Physicians Treating Victims of Motor Vehicle Accidents