.jpg "Stephanie Jarvis photo")
Patrick Rudersdorf, MD
Cardiothoracic Surgeon
St. Anthony Hospital, United States
Disclosure information not submitted.
James Poling, MD
General Surgeon
St. Anthony Hospital, United States
Disclosure information not submitted.
Andreas Hennig, MD
General Surgeon
St. Anthony Hospital, United States
Disclosure information not submitted.
.jpg "Kristin Salottolo, MPH photo")
Kristin Salottolo, MPH
Clinical Epidemiologist
St. Anthony Hospital
Lakewood, CO
Disclosure information not submitted.
Travis Bouchard, MD
General Surgeon
Swedish Medical Center, United States
Disclosure information not submitted.
Allen Tanner, MD
Trauma Medical Director
Duke University Hospital, United States
Disclosure information not submitted.
Wendy Erickson, RN
Trauma Program Manager
Penrose Hospital, United States
Disclosure information not submitted.
Sidra Bhuller, DO
General Surgeon
Research Medical Center, United States
Disclosure information not submitted.
Logan Ouderkirk, MD
General Surgeon
Wesley Medical Center, United States
Disclosure information not submitted.
Jeffrey Simpson, MD
General Surgeon
Research Medical Center, United States
Disclosure information not submitted.
Kaysie Banton, MD, MHA,FCCM
Trauma Medical Director
Swedish Medical Institute, United States
Disclosure information not submitted.
Elizabeth Kim, MD
General Surgeon
Medical City Plano, United States
Disclosure information not submitted.
David Bar-Or, MD
Director of ION Research
Swedish Medical Center Cherry Hills Campus, United States
Disclosure information not submitted.
Title:The Association Between Elevation and Traumatic Aortic Injuries
Introduction: Traumatic Aortic Injuries (TAI) are rare but result in greater than 80% fatality. Prior studies have shown skiers and pilots are at an increased risk for TAI, this could be due to the high altitude where these events occur. We hypothesize that elevation will affect both incidence and characteristics of TAI.
Methods: This retrospective cohort study at six Level I trauma centers (4/2016-12/2019) included adult blunt trauma patients with a chest or abdomen injury. High elevation injuries ( > 5000 ft) were compared to low elevation injuries (≤ 5000 ft). Outcomes included: incidence of TAI, TAI location (thoracic or abdominal), and aortic diameter. The incidence of TAI was examined with multivariate firth logistic regression due to rarity.
Results: There were 8562 trauma patients, 37% (3187) high elevation and 63% (5375) low elevation. High elevation patients were older (p< 0.01), more likely to be white (p< 0.01) and had a higher ISS (p< 0.01). There were 94 (1.1%) TAIs. There was a significantly greater incidence of TAI at high elevations than low elevations (1.5% vs. 1.1%, p=0.01). The median elevation was also significantly higher for patients with a TAI than for patients without a TAI (5100 vs. 1400 feet, p=0.01). The median aortic diameter was similar between groups (28 vs. 30 mm, p=0.72). The proportion of thoracic and abdominal TAIs were similar between groups (p=0.79 and p=0.08). After adjustment, high elevation patients had 2-fold (OR: 2.4, 95% CI, 1.5, 3.7) greater odds of having a TAI than low elevation patients.
Conclusions: TAIs were more common among high elevation injuries. Providers should be aware of the increased incidence of TAI at high elevations because of the high mortality rate, especially when left untreated. Screening for TAI among high-mechanism injuries and injuries associated with TAI at high elevation trauma centers may lead to earlier diagnosis, earlier treatment, and ultimately better survival rates.