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Who benefits from resuscitative thoracotomies following penetrating trauma: The patient or the learner?
Atkins, Kathryn; Schneider, Andrew; Gallaher, Jared; Cairns, Bruce; Charles, Anthony.
Afiliación
  • Atkins K; Department of Surgery, University of North Carolina at Chapel Hill, USA.
  • Schneider A; Department of Surgery, University of North Carolina at Chapel Hill, USA.
  • Gallaher J; Department of Surgery, University of North Carolina at Chapel Hill, USA.
  • Cairns B; Department of Surgery, University of North Carolina at Chapel Hill, USA.
  • Charles A; Department of Surgery, University of North Carolina at Chapel Hill, USA. Electronic address: anthchar@med.unc.edu.
Injury ; 54(11): 111033, 2023 Nov.
Article en En | MEDLINE | ID: mdl-37716863
BACKGROUND: Resuscitative thoracotomy (RT) is a salvage procedure following traumatic cardiac arrest. We aim to evaluate RT trends and outcomes in adults with cardiac arrest following penetrating trauma to determine the effect on mortality in this population. Further, we aim to estimate the effect of hospital teaching status on the performance of resuscitative thoracotomies and mortality. METHODS: We reviewed the National Trauma Data Bank (2017-2021) for adults (≥16 years old) with penetrating trauma and prehospital cardiac arrest, stratified by the performance of a RT. We performed multivariable logistic regressions to estimate the effect of RT on mortality and the effect of hospital teaching status on the performance of resuscitative thoracotomies and mortality. RESULTS: 13,115 patients met our inclusion criteria. RT occurred in 12.7% (n = 1,664) of patients. Rates of RT trended up over the study period. Crude mortality was similar in RT and Non-RT patients (95.6% vs. 94.5%, p = 0.07). There was no statistically significant difference in the adjusted odds of mortality based on RT status (OR 0.82, 95%CI 0.56-1.21). University-teaching hospitals had an adjusted odds ratio of 1.68 (95% CI 1.31-2.17) for performing a RT than non-teaching hospitals. There was no difference in the adjusted odds of mortality in patients that underwent RT based on hospital teaching status. CONCLUSION: Despite up-trending rates, a resuscitative thoracotomy may not improve mortality in adults with penetrating, traumatic cardiac arrest. University teaching hospitals are nearly twice as likely to perform a RT than non-teaching hospitals, with no subsequent improvement in mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Heridas Penetrantes / Paro Cardíaco Límite: Adolescent / Adult / Humans Idioma: En Revista: Injury Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Heridas Penetrantes / Paro Cardíaco Límite: Adolescent / Adult / Humans Idioma: En Revista: Injury Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos