Sex Differences in Blunt Traumatic Aortic Injury from the Aortic Trauma Foundation Global

P0299 

Abstract Submission 

Lucas Ribe (1), Yuki Ikeno (1), Rana Afifi (2), Akiko Tanaka (3), Christopher Rosa (4), Naveed Saqib (3), Harleen Sandhu (5), Charles Miller (6), Anthony Estrera (3), Gustavo Oderich (1)

(1) McGovern Medical School at UTHealth, Houston, TX, (2) Memorial Hermann, Houston, TX, (3) Memorial Hermann Heart and Vascular Institute, Houston, TX, (4) Memorial Hermann Hospital. UTHealth., Houston, TX, (5) N/A, HOUSTON, TX, (6) Memorial Hermann Texas Medical Center, Houston, TX

Lucas Ribe    -  Contact Me
McGovern Medical School at UTHealth

Yuki Ikeno    -  Contact Me
McGovern Medical School at UTHealth

Rana Afifi    -  Contact Me
Memorial Hermann

Akiko Tanaka    -  Contact Me
Memorial Hermann Heart and Vascular Institute

Christopher Rosa    -  Contact Me
Memorial Hermann Hospital. UTHealth.

Naveed Saqib    -  Contact Me
Memorial Hermann Heart and Vascular Institute

Harleen Sandhu    -  Contact Me
N/A

Charles Miller    -  Contact Me
Memorial Hermann Texas Medical Center

*Anthony Estrera    -  Contact Me
Memorial Hermann Heart and Vascular Institute

Gustavo Oderich    -  Contact Me
McGovern Medical School at UTHealth

Lucas Ribe    -  Contact Me
McGovern Medical School at UTHealth

Objective

Trauma is the leading cause of death in people younger than 45 years. Blunt traumatic aortic injury (BTAI) is the second most common cause of death after blunt trauma. There have been reports on the different response to trauma between men and women, as well as sex/gender disparities in aortic diseases, including aneurysms and dissections, in terms of outcomes. However, there is a gap in the literature regarding sex differences in patients with BTAI.

Methods

The Aortic Trauma Foundation international prospective multicenter registry was utilized to investigate sex differences in traumatic aortic injury characteristics, management, and outcomes from 2016 to 2023. Data were analyzed using contingency tables and stratified and multivariable regression.

Results

There were 781 patients with BTAI and complete injury grade information, of whom 182 patients (23%) were female. The mean age was 43.4 ± 18 years, and women were significantly older than men (48 ± 18.6 vs. 42.3 ± 17.6, p < 0.0001). Four hundred sixty-four patients (59%) underwent TEVAR, with no significant difference between men (61%, 364/599) and women (55%, 100/182). Injury severity score and Glasgow Coma Scale scores did not differ between women and men. Women more often had pelvic fractures (41% vs. 30%, p < 0.004), splenic injuries (31% vs. 23%, p < 0.05), renal injuries (22% vs. 14%, p < 0.02), sacral spine fractures (12% vs. 6%, p < 0.02), and sternal fractures (17% vs. 10%, p < 0.02), but these injury patterns were not associated with higher-grade aortic injuries. There were no sex differences in the distribution of aortic injury grade. In-hospital mortality was 12%, and aortic-related mortality was 4% for the entire cohort, with no differences between men and women. The presence of sternal fracture appeared to predict higher aortic mortality in women (10% with sternal fracture vs. 2% without, p = 0.05), but not in men (9% with sternal fracture vs. 10% without, p = 0.9).

Conclusions

Women with BTAI presented more frequently with intra-abdominal and pelvic injuries, and sternal fractures appeared to predict higher mortality in women with BTAI. No differences in mortality were found between men and women with BTAI.

Trauma