Epidemiology of Traumatic Esophageal Injury: An Analysis of the National Trauma Data Bank
Xu, Alexander.
2018
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Abstract: Introduction: Traumatic injury of the esophagus (TIE) is rare, and
the existing literature is limited. The aim of this descriptive study was to
comprehensively describe the clinical characteristics and outcomes of TIE among trauma
patients using the National Trauma Data Bank (NTDB). Methods: Patients with TIE from
2010-2015 were identified in the NTDB by the Abbreviated Injury Scale.... read moreThe prevalence of
TIE among trauma patients was estimated. The demographic and clinical characteristics and
hospital outcomes, including hospital length of stay, complications, and mortality, of
these patients were further analyzed according to injury mechanism, injury severity score
(ISS), and sex. Results: 1,411 adult patients with TIE were identified. The prevalence of
TIE among all trauma patients was 37 patients per 100,000 (95% CI: 35, 39). The prevalence
of TIE was 257 cases per 100,000 (95% CI: 250, 270) among patients with penetrating trauma
and 16 cases per 100,000 (95% CI: 15, 18) among patients with blunt trauma. Patients with
ISS ≥ 25 were 34 times more likely to have TIE than those with ISS 0-9, and TIE was almost
3 times more likely in males as compared to females. Among cases of TIE, 523 (37%) were
blunt and 888 (63%) were penetrating. Compared to those with blunt TIE, patients with
penetrating TIE were significantly younger (34 vs 46 years), more likely to be male (85% vs
74%), and were more severely injured (ISS ≥ 25: 48% vs 40%) (all p < 0.001). Patients
with blunt TIE were more likely to have associated spine injuries as compared to those with
penetrating TIE (43% vs 27%, p < 0.001). Overall in-hospital mortality in patients with
TIE was 19%, and patients with TIE had significantly higher mortality than those without
after adjusting for age, sex, and ISS (OR = 1.4, 95% CI: 1.1, 1.7). There was no
statistically significant difference in mortality between blunt and penetrating TIE in both
crude analysis (20% vs 18%) and multivariable adjusted analyses. Conclusion: TIE is
associated with more severe injuries, male sex, and penetrating trauma. Mortality is
markedly elevated in trauma patients with TIE but is not associated with mechanism of
injury.
Thesis (M.S.)--Tufts University, 2018.
Submitted to the Dept. of Clinical & Translational Science.
Advisor: Jessica Paulus.
Committee: Janis Breeze, and Nikolay Bugaev.
Keyword: Surgery.read less - ID:
- r781wt54z
- Component ID:
- tufts:25444
- To Cite:
- DCA Citation Guide EndNote
