Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Analysis of Aspiration Risk Factors in Severe Trauma Patients: Based on Findings of Aspiration Lung Disease in Chest Computed Tomography

  • Heo, Gyu Jin (Department of Emergency Medicine, Gil Medical Center) ;
  • Lee, Jungnam (Department of Traumatology, Gil Medical Center, Gachon University College of Medicine) ;
  • Choi, Woo Sung (Department of Emergency Medicine, Gil Medical Center) ;
  • Hyun, Sung Youl (Department of Traumatology, Gil Medical Center, Gachon University College of Medicine) ;
  • Cho, Jin-Seong (Department of Emergency Medicine, Gil Medical Center, Gachon University College of Medicine)
  • Received : 2020.04.28
  • Accepted : 2020.06.30
  • Published : 2020.06.30
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Abstract

Purpose: The present study will identify risk factors for aspiration in severe trauma patients by comparing patients who showed a sign of aspiration lung disease on chest computed tomography (CT) and those who did not. Methods: We conducted a retrospective review of the Korean Trauma Data Bank between January 2014 and December 2019 in a single regional trauma center. The inclusion criteria were patients aged ≥18 years with chest CT, and who had an Injury Severity Score ≥16. Patients with Abbreviated Injury Scale (AIS)-chest score ≥1 and lack of medical records were excluded. General characteristics and patient status were analyzed. Results: 425 patients were included in the final analysis. There were 48 patients showing aspiration on CT (11.2%) and 377 patients showing no aspiration (88.7%). Aspiration group showed more endotracheal intubation in the ER (p=0.000) and a significantly higher proportion of severe Glasgow Coma Scale (GCS) (p=0.000) patients than the non-aspiration group. In AIS as well, the median AIS head score was higher in the aspiration group (p=0.046). Median oxygen saturation was significantly lower in the aspiration group (p=0.002). In a logistic regression analysis, relative to the GCS mild group, the moderate group showed an odds ratio (OR) for aspiration of 2.976 (CI, 1.024-8.647), and the severe group showed an OR of 5.073 (CI, 2.442-10.539). Conclusions: Poor mental state and head injury increase the risk of aspiration. To confirm for aspiration, it would be useful to perform chest CT for severe trauma patients with a head injury.

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References

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