BACKGROUND: Oesophageal trauma is uncommon. The aim of this study was to conduct a descriptive analysis of penetrating oesophageal trauma and determine risk factors for oesophageal related complications and mortality in the National Trauma Data Bank (NTDB). METHODS: Patients with penetrating oesophageal trauma from Levels 1 and 2 trauma centres in the NTDB (2007 and 2008) that specified how complication and comorbidity data were recorded were selected. Data collected included age, injury severity score (ISS), abbreviated injury scores (AIS), lengths of stay (LOS) and ventilation days, systolic blood pressure (SBP) in the emergency department (ED), comorbidities, oesophageal related procedures, and oesophageal related complications. Univariate and multivariable analyses were conducted to identify significant predictors of oesophageal-related complications and mortality in patients with LOS>24 h. RESULTS: 227 patients from 107 centres were studied. The mean number of patients per centre was 2 (range 1-15). Overall mortality was found to be 44% with 92% of these deaths in less than 24 h. In patients with LOS>24 h, 62% had primary repair, 13% drainage, 4% resection, 1% diversion, and 20% unspecified. No significant difference in mortality was found in patients with oesophageal related complications. The time to first oesophageal related procedure was not significantly different in those with oesophageal related complications or those who died. Significant predictors of oesophageal related complications were age and AIS of the abdomen or pelvic contents ≥3 and the only significant predictor of mortality was ISS. CONCLUSIONS: Most deaths in penetrating oesophageal trauma occur in the first 24 h due to severe associated injuries. Primary repair was the most common intervention, followed by drainage and resection. Oesophageal related complications were not found to significantly increase mortality and time to first oesophageal related procedure did not affect outcomes in this subset of patients from the NTDB.
BACKGROUND:Oesophageal trauma is uncommon. The aim of this study was to conduct a descriptive analysis of penetrating oesophageal trauma and determine risk factors for oesophageal related complications and mortality in the National Trauma Data Bank (NTDB). METHODS:Patients with penetrating oesophageal trauma from Levels 1 and 2 trauma centres in the NTDB (2007 and 2008) that specified how complication and comorbidity data were recorded were selected. Data collected included age, injury severity score (ISS), abbreviated injury scores (AIS), lengths of stay (LOS) and ventilation days, systolic blood pressure (SBP) in the emergency department (ED), comorbidities, oesophageal related procedures, and oesophageal related complications. Univariate and multivariable analyses were conducted to identify significant predictors of oesophageal-related complications and mortality in patients with LOS>24 h. RESULTS: 227 patients from 107 centres were studied. The mean number of patients per centre was 2 (range 1-15). Overall mortality was found to be 44% with 92% of these deaths in less than 24 h. In patients with LOS>24 h, 62% had primary repair, 13% drainage, 4% resection, 1% diversion, and 20% unspecified. No significant difference in mortality was found in patients with oesophageal related complications. The time to first oesophageal related procedure was not significantly different in those with oesophageal related complications or those who died. Significant predictors of oesophageal related complications were age and AIS of the abdomen or pelvic contents ≥3 and the only significant predictor of mortality was ISS. CONCLUSIONS: Most deaths in penetrating oesophageal trauma occur in the first 24 h due to severe associated injuries. Primary repair was the most common intervention, followed by drainage and resection. Oesophageal related complications were not found to significantly increase mortality and time to first oesophageal related procedure did not affect outcomes in this subset of patients from the NTDB.
Authors: Alexander A Xu; Janis L Breeze; Carl-Christian A Jackson; Jessica K Paulus; Nikolay Bugaev Journal: Pediatr Surg Int Date: 2019-05-10 Impact factor: 1.827
Authors: Daniel Dante Yeh; John O Hwabejire; Marc de Moya; David R King; Peter Fagenholz; Haytham Ma Kaafarani; Eric N Klein Journal: J Emerg Trauma Shock Date: 2015 Jan-Mar
Authors: Mircea Chirica; Michael D Kelly; Stefano Siboni; Alberto Aiolfi; Carlo Galdino Riva; Emanuele Asti; Davide Ferrari; Ari Leppäniemi; Richard P G Ten Broek; Pierre Yves Brichon; Yoram Kluger; Gustavo Pereira Fraga; Gil Frey; Nelson Adami Andreollo; Federico Coccolini; Cristina Frattini; Ernest E Moore; Osvaldo Chiara; Salomone Di Saverio; Massimo Sartelli; Dieter Weber; Luca Ansaloni; Walter Biffl; Helene Corte; Imtaz Wani; Gianluca Baiocchi; Pierre Cattan; Fausto Catena; Luigi Bonavina Journal: World J Emerg Surg Date: 2019-05-31 Impact factor: 5.469
Authors: Jan C Vázquez-Rodríguez; Natalia M Pelet Del Toro; Omar García-Rodríguez; Ediel Ramos-Meléndez; Julio López-Maldonado; Felipe Rodríguez; Jorge Pelet Mejías; Pablo Rodríguez-Ortiz Journal: Ann Med Surg (Lond) Date: 2019-06-28
Authors: Austin Rogers; Rob Allman; Fernando Brea; Dean Yamaguchi; Aundrea Oliver; James Speicher; Mark Iannettoni; Carlos Anciano Journal: JTCVS Tech Date: 2022-05-21