Hanna Kamil, Okumura Kenji, Shnaydman Ilya
Department of Surgery, Westchester Medical Center, USA.
Department of Surgery, Westchester Medical Center, USA.
Am J Surg. 2022 Dec;224(6):1393-1397. doi: 10.1016/j.amjsurg.2022.10.037. Epub 2022 Oct 17.
Motor vehicle collisions (MVCs) can cause blunt cerebrovascular injury (BCVI). Exploring MVC characteristics that increase BCVI may reduce missed injuries. This study aims to evaluate the association between airbag deployment and BCVI.
We analyzed the 2016-Trauma Quality Improvement Database including adult MVC drivers. Patients were stratified: airbag deployment(A+) and no-airbag deployment(A-). Outcomes were BCVI, and cervical spine injuries (CSI).
A total of 122,973 patients were identified: A+: 106,492, and A-: 16,481. The incidence of BCVI was 1907 (1.6%): and CSI was 20,711 (16.8%). A+ patients had a higher rate of BCVI (1.6% vs. 1.1%; p < 0.001), but a lower rate of CSI (16.2% vs. 21.4%; p < 0.001). On regression analysis, A+ was associated with BCVI (1.419[1.184-1.701]; p < 0.001) but was protective for CSI (0.767[0.672-0.878]; p < 0.001).
A+ may be an unrecognized risk factor for BCVI even for patients without a CSI. Expanding BCVI screening criteria to include A+ may reduce missed injuries.
Level III, prognostic.
机动车碰撞（MVC）可导致钝性脑血管损伤（BCVI）。探索增加BCVI的MVC特征可能会减少漏诊损伤。本研究旨在评估安全气囊展开与BCVI之间的关联。
我们分析了2016年创伤质量改进数据库，其中包括成年MVC驾驶员。患者被分层：安全气囊展开（A+）和未展开安全气囊（A-）。结局指标为BCVI和颈椎损伤（CSI）。
共识别出122973例患者：A+组106492例，A-组16481例。BCVI的发生率为1907例（1.6%），CSI的发生率为20711例（16.8%）。A+组患者的BCVI发生率较高（1.6%对1.1%；p<0.001），但CSI发生率较低（16.2%对21.4%；p<0.001）。回归分析显示，A+与BCVI相关（1.419[1.184-1.701]；p<0.001），但对CSI有保护作用（0.767[0.672-0.878]；p<0.001）。
即使对于没有CSI的患者，A+也可能是BCVI的一个未被认识的危险因素。扩大BCVI筛查标准以纳入A+可能会减少漏诊损伤。
三级，预后性。
