P299. Sex Differences in Blunt Traumatic Aortic Injury from the Aortic Trauma Foundation Global
McGovern Medical School at UTHealth
Houston, TX
United States - Contact Me
Avanced Aortic Surgery Fellow at Memorial Hermann Hospital, Houston.
I currently live in Houston, where I am completing a two- year Fellowship in advanced aortic surgery. I am greatly engaged in open surgery for aortic aneurysms and dissections, as well as in modern vascular surgery, with large interest in vascular innovations, latest technology in vascular and aortic endovascular surgery, and greatly interested in medical and academic education, as well as surgical simulation.
I previously joined La Fe University Hospital in 2014 as a junior physician in angiology and vascular surgery, within the department of vascular surgery.
Prior to La Fe, I was the first Spanish junior vascular surgeon to complete a senior clinical Fellowship in aortic surgery at St. Mary’s Hospital, Imperial College of London, during an 18- month period,
and one of the first Spanish surgeons to become an official fellow of the European board of vascular and endovascular surgery (FEBVS).
Prior to this experience, I completed my residency in vascular surgery at Gregorio Marañón University hospital in Madrid, during a five- year period.
During my tenure in Madrid, I helped the hospital with the medical and residents training program, and participated in several national and international simulation courses, workshops, and meetings.
I am a graduate of the University of Alcala in Madrid, where I majored my bachelor in medicine.
Description
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.
Authors
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)
Institutions
(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