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23rd European Congress of Trauma & Emergency Surgery

Impact of the implementation of a trauma center in a third-level university hospital: Our experience

Trauma and Emergency surgery | Miscellaneous

Polytrauma

INTRODUCTION. Whereas in the US the concept that traumatic pathology should be treated by a dedicated team is well rooted, its acquisition in Italy is relatively recent. In 2016 Azienda Ospedaliero Universitaria Careggi (AOUC), became part of the National Trauma Network as Trauma Center (TC) and The Trauma Team (TT) was officially established on 1st August 2018. AIM OF THE STUDY. To evaluate whether the introduction of the TT has led to an improvement in the management and the outcomes of polytraumas and to assess whether and eventually how the decision-making process in the execution of surgical and/or interventional procedures has changed. MATERIALS AND METHODS. This is a non-randomized single-center retrospective data collection on a consecutive series of major trauma patients who accessed the AOUC Shock Room in the 20 months prior to the establishment of the TT (preTT group) and in the following 20 months (postTT group). RESULTS. In the study period (1st December 2016 – 31st March 2020), 947 patients were admitted in the ER due to a traumatic event. Patients were 418 in the preTT and 529 in the postTT group. Comparing the 2 periods, a significative decrease in time spent in SR (p=0,008), in SOFA score at the entrance in ICU department (p=0,027) and in estimated blood losses in Operating Room (p=0,0026) was observed. Instead, the number of days of assisted ventilation (p&lt;0,001), the number of Damage Control Surgery procedures (p=0,0078) and NOMs for splenic and liver injuries (p=0,004) significantly increased. CONCLUSIONS. A significant change in the type of surgical procedures performed and a significant increase in number of NOMs was observed in the period following the implementation of the TC; this is particularly evident in splenic trauma management, where a complete alignment with the WSES guidelines recommendations was obtained. For these reasons, the management of traumatic pathology with a dedicated Trauma Team represents the best approach to polytraumas.No

Poster

Assessing prehospital delays in access to level 1 and 2 trauma centers in Riyadh, Saudi Arabia

Research

Introduction: Trauma is the leading cause of mortality in Saudi Arabia. Access to trauma care in major cities has not been previously studied. Objective: To evaluate regional variations in access to trauma care in Riyadh. Methods &amp; Materials: We analyzed trauma incident reports from 50 dispatch centers using the Red Crescent registry between January 2021 and March 2023. Inclusion criteria included adult trauma cases classified under red criteria (Systolic Blood Pressure (SBP)&lt;90mmHg or heart rate&gt;SBP). We used QGIS to map dispatch center locations and delineated level 1 and 2 trauma center service zones at 15, 30, 45, and 60-min intervals based on road networks. We compared this to actual travel time and considered travel time &gt;60mins as a delay. Results: Among red criteria cases (n=17983), nearly half were blunt (n=8782, 48.8%) and the other half penetrating (n=8577, 47.7%). Other trauma (burns, etc.) accounted for the remaining 3.5% (n=624). Distribution of dispatch centers was uneven with the majority located in east (n=20/50, 40%) and north of Riyadh (n=13/50, 26%), followed by west (n=7/50, 14%), south (n=6/50, 12%) and middle (n=4/50, 8%). Over a third of all cases experienced delays (n=6,444, 35.8%), with all dispatch centers experiencing delays ranging from 29-83% (Fig 1). Majority of delays occurred in the north (n=1568/4031, 38.9%) and east (n=2719/7470, 36.4%), even though nearly all (11456/11501, 99.6%) activations were located within a 45-min service area. In addition, nearly a third of cases were delayed in the west (n=883/2586, 34.1%), south (n=774/2363, 32.8%) and middle (n=500/1533, 32.6%), despite all activations being within a 30-min service area. Conclusion: Despite geographical proximity to trauma centers, regional delays in transport time to trauma centers highlight challenges within the prehospital transportation system. Findings of this study can guide targeted interventions in areas of frequent delays to improve access to care.No.

Evaluating prehospital mistriage of trauma patients to non-trauma centers in Riyadh, Saudi Arabia

Introduction: Trauma is the leading cause of mortality in Saudi Arabia. The risk of mortality is lower when trauma care is provided in a trauma center compared to a non–trauma center. Objective: To evaluate incidence of prehospital mistriage by assessing the transportation of trauma patients to non-trauma centers in Riyadh. Methods &amp; Materials: We analyzed 17983 incident reports from 50 dispatch centers using the Red Crescent Authority registry between January 2021 and March 2023. Inclusion criteria included adult trauma cases classified under red criteria (Systolic Blood Pressure (SBP)&lt;90mmHg or heart rate&gt;SBP). We used QGIS to map dispatch center and non-trauma center locations, delineating level 1 and 2 trauma center service zones at 15, 30, 45, and 60-min intervals to determine theoretical accessibility to timely trauma care. Dispatch centers were categorized within these service areas to assess mistriaging of red criteria cases to non-trauma centers. Results: Nearly a third of the red criteria cases (n=5105/17983, 28.8%) were mistriaged, primarily involving blunt injuries (n=3316, 65%), followed by penetrating (n=1604, 31.4%) and others (n=185, 3.6%). A higher rate of mistriage was observed in the 45- and 60-min service areas (n=930/2917, 31.9% and n=20/45, 44.4%, respectively), particularly in the east (n=2013/5105, 39.4%) and north (n=1522/5105, 29.8%). Mistriage rate ranged from 4.5%-66.8% for each dispatch center (Fig 2), with the highest rates noted in Alkharj located in 30-min service area in east Riyadh (n=163/244, 66.8%) followed by Alamana located in 45-min service area in north Riyadh (n=117/186, 62.9%). Conclusion: Mistriage rates were highest in the 45- and 60-min service areas, indicating a greater likelihood of non-trauma center transfers when trauma centers were farther away. To optimize access to trauma centers for critically ill patients, expansion of trauma care infrastructure and stricter implementation of triaging protocols is needed. No.

Prof. Dr.

Prediction of triage level, MTP activation and mortality, using machine learning models in trauma care

Background: Effectively managing trauma patients requires accurate prediction of efficient triaging and timely activation of Massive Blood Transfusion Protocols (MTP). Machine learning (ML) algorithms have emerged as highly promising tools in the domains of predicting clinical outcomes and optimizing triage decisions and intervention strategies, consistently outperforming traditional methodologies. We aimed to assess and compare ML models for the prediction of trauma triaging processes, activation of MTP, and mortality. Methods: In this 10-year retrospective study, including 17,390 patients, we analyzed the predictive capabilities of seven ML models for overall trauma patients as well as for hemodynamics data subset. Employing Python 3.9 for data preprocessing, feature scaling, and model development, we evaluated K-Nearest Neighbors (KNN), Logistic Regression (LR), Decision Tree (DT), Support Vector Machines (SVM) with RBF kernels, Random Forest (RF), Extreme Gradient Boosting (XGBoost), and Artificial Neural Network (ANN). We employed various imputation techniques and addressed data imbalance through down-sampling, up-sampling, and SMOTE. Hyperparameter tuning, coupled with 5-fold cross-validation, was performed. The evaluation included essential metrics like sensitivity, specificity, F1 score, accuracy, and AUC, ensuring robust predictive capability. Result: 3,385 patients were triaged as critical cases, 3.8% (664 patients) required MTP activation, and 7.7% (1,335 patients) had mortality. Imputation improved performance, and most models performed better with balancing techniques. The overall models demonstrated notable performance metrics for predicting mortality, triage, and MTP activation, with F1 scores of 0.79, 0.75, and 0.42, sensitivities of 0.9, 0.73, and 0.82, and AUC values of 0.99, 0.89, and 0.95, respectively. Conclusion: ML models demonstrated robust predictive capabilities for triage, MTP activation, and mortality, which may improve trauma outcomes.none to declare

Accuracy of the Norwegian trauma protocol. An observational population study from South Western Norway

Background The Norwegian trauma plan was renewed in 2017 defining new national trauma team activation criteria. Previous Norwegian studies validating the performance of previous TTA protocols have found overtriage and undertriage to be out of line with the quality predictors set in the national trauma plan, but studies have not yet been published validating the new TTA protocol. Material and method The study is a registry study of a prospectively maintained database. Data was collected from the Trauma Registry and prehospital documents. A total of 1519 patients were identified, of which 317 were excluded. Overtriage, undertriage, sensitivity, spescificity, PPV, NPV and were analysed for the total population, criteria groups and single criteria. Results The present TTA protocol (1+2+3) had a total sensitivity of 85%, specificity of 31%, overtriage of 81%, and undertriage of 15%. A protocol including all four criteria groups (1+2+3+4), or a protocol omitting MOI (1+2+4) have a better sensitivity, and lower undertriage (94% and 92%), without significantly increasing overtriage (82% and 81%), but reduces specificity. Criteria group 3 MOI was the criteria group with the most overtriage with 95%, and patients that did not meet any criteria had a similar overtriage of 94%. Conclusion Mechanism of injury is a poor predictor of severe injury and causes a major degree of overtriage. Sensitivity in the current protocol is not sufficient for older patients that have a low energy trauma mechanism and the TTA criteria are more prone to undertriage older patients in general. The protocol could be improved by removal of single criteria with low PPV and by better compliance to the criteria. References 1: Norsk kompetansetjeneste for traumatologi. Traumeplan NKTNo

A comparative analysis between a local and aggregate trauma quality improvement program (TQIP) data: Insights from a middle eastern level 1 trauma center

Background: One of the TQIP&quot;s most important features is that it allows for validation and risk-adjusted analyses, which are crucial for assessing trauma outcomes. Trauma Quality Improvement Program- The American College of Surgery (ACS-TQIP uses the existing infrastructure of the Committee on Trauma programs and provides feedback to participating hospitals on risk-adjusted outcomes. We analyzed and compared the performance of the Hamad Trauma Centre (HTC) with the aggregate TQIP participating centers data (April 2019-March 2020 to April 2020-March 2021). We explored the variations in trauma outcomes and quality measures, identified areas that need improvement, and leveraged existing resources to facilitate quality improvement. Methods: We used the TQIP methodology, inclusion and exclusion criteria and outcomes. Results: 915 patients were qualified for the TQIP database. HTC patients&quot; demographics differed from the TQIP's aggregate data; they were younger, male, and had significantly different mechanisms of injury. During the Fall 2020, HTC was a low outlier (good performer) in one cohort (all patients) and an average performer in the remaining cohorts. However, during Fall 2021, HTC showed improvement and low outlier in two cohorts (all patients and severe TBI patients). Overall, HTC remained an average performer during the report cycles. Conclusions: our analysis showed a potential temporal improvement in the risk-adjusted mortality, reflecting the continuous and demanding effort put together by the trauma team. ACS-TQIP for external benchmarking of quality improvement could be a contributor to better monitored patient care. Evaluating TQIP data with an emphasis on appropriate methodologies, quality measurements, corrective measures, and accurate reporting is warranted. Analyzing TQIP database reports with a focus on quality measures and accurate reporting will reveal TQIP data to be beneficial for improving patient care after implementing corrective measuresnone to declare

Trauma in elderly in the Middle East: A 10-Year analysis

Introduction: Geriatric trauma is challenging in its prevention and management. The reason is multifactorial and related to the aging process, comorbid conditions, and decreased physiologic reserve. Aggressive management has shown to be successful in helping these vulnerable groups of injured patients gain a better quality of life. We aimed to analyze the prevalence, risk factors, and pattern of injuries among the geriatric population over ten years. Method: A retrospective analysis of Qatar National Trauma Registry data was conducted from 2010 to 2021. The data included epidemiologic, type of injury, and clinical outcomes (including morbidity, disposition, length of stay, and mortality). Comparative analysis of data by age groups (55-64 vs.≥65 yrs.), gender (male vs. female), and outcome (survivors vs. deceased). Results: Out of 15,000 trauma admissions, 1626 (11%) were geriatrics (mean age 65.5±9.5 yrs., female (17.5%), and mean injury severity score (ISS) of 12.9±8.8. The injury rate for the ≥ 65 was 24 per 10,000 compared to 10 per 10,000 in the younger group, showing a decreasing trend throughout the study. Thirty-five percent of injuries were at home. The most common mechanism of injury was falls (46%), followed by traffic-related injuries (45.5%). The most common injured regions were the chest (45%), lower limbs (31%), head (28%), and abdomen (11%). The median length of hospital stay was six days. Males had more head, chest, and abdominal injuries and higher mortality than females (9% vs. 4%). The deceased were three years older (62 vs. 59), had more head injuries, and received more blood with higher MTP activations. The overall mortality rate was 8%. Conclusion: One out of ten trauma admissions aged ≥55 years. Falls are the main MOI, and one-third of injuries occur at home. There has been a significant decrease in geriatric injuries in our population over the years. Head injury and bleeding are the leading causes of mortality among the aging population.Nothing to disclose and we have no conflict of interest

Clinicians' attitude towards supplemental oxygen for trauma patients

Introduction: Supplemental oxygen treatment is often liberally administered in trauma care as recommended by international trauma guidelines. However, supplemental oxygen has been associated with pulmonary complications and increased mortality in trauma patients with normal arterial oxygen saturation (SpO2). Therefore, clinicians may not follow the recommendations. Objectives: We aimed to assess the attitude and intended supplemental oxygen use in clinical practice among clinicians defined as pre- and in-hospital physicians and pre-hospital personnel (e.g., paramedics and ambulance nurses). Materials &amp; methods: We conducted an online survey consisting of 23 questions. The primary outcome was addressed in the question: "In your opinion, should all severely injured trauma patients always be given supplemental oxygen, regardless of SpO2?". Results: The invitation to participate in the survey was distributed among 1359 clinicians in 12 countries from May to August 2023. The total number of responders was 707 (52%), and of these, 651 (92%) completed the survey. The educational background of the responders comprised medical doctors (62%), paramedics (36%) and others (2%). Among medical doctors, 400 (92%) were certified specialists. When evaluating the primary outcome, 73% answered "no". The median value of the lowest acceptable SpO2 goal in the first few hours after trauma was 94%. For spontaneously breathing trauma patients with a normal SpO2 in the first few hours after trauma, 58% answered that no supplemental oxygen should be administered. For intubated trauma patients with a normal SpO2, the median value of the chosen lower and upper limit of FiO2 was 0.30 (IQR 0.21-0.40) and 0.51 (IQR 0.40-0.80), respectively. Conclusion: This international survey on clinicians' attitudes towards supplemental oxygen for trauma patients indicates a discrepancy between international trauma guidelines and clinicians' attitudes and their clinical intentions in trauma.No.

Obstetric trauma due to gunshot wound and fetal femur fracture: A case report

Emergency surgery

Case history: A 26 year old woman who reported being 9 months pregnant, but without prior prenatal care, was brought to Emergency Department by ambulance due to a gunshot wound 4 hours ago. The patient had used crack earlier that day and was in her sixth pregnancy. Clinical findings: During primary care, 2 injuries were identified, with 2 entry holes in infraclavicular region on the right, but only one exit hole in the right shoulder. Investigations/Results: Patient had severe abdominal pain and uterine hypertonus, but no vaginal bleeding. Diagnosis: The Hospital&quot;s Obstetrics Team identified a probable placental abruption and recommended an urgent cesarean section. The baby was born alive and had a bitrochanteric perforative lesion. Therapy and Progressions: After the cesarean section, the surgery team opted to perform an exploratory laparotomy. The projectile was found in the subcutaneous tissue of the abdominal region. Epiplon hematoma in the transverse colon loop and liver laceration in active bleeding were also identified. Futhermore, it was decided to perform right thoracic dranage, due to the thoraco-abdominal trajectory of the projectile and suspicion of hemothorax. The patient evolved well and was discharged. The Orthopedics Team evaluated the bitrochanteric injury in the baby, with moderate bleeding and no pulse in the right limb. The next day, he presented 3 cardiorespiratory arrests (CPA) and didn&quot;t survive the reamination maeuvers, being declared dead. Comments: Although trauma during pregnancy is the main non obstetric cause of maternal fetal death, it is observed that there is still a lack of scientific articles on the approaches and management of trauma caused by gunshot in pregnant women, which contributes to a higher rate of maternal and fetal mortality, The uniqueness of the case requires decision making guided by a meticulous assessment of the risk and benefits of the intervention, as well as a specialized and guided multidisciplinary teamNo

Prof.

Survival prediction in injured children: Validation of trauma scales in Colombia

Introduction: Trauma is one of the main causes of death and disability in children and adolescents. Among the strategies to reduce mortality are the use of predictive survival scales and the evaluation of the quality of care in trauma centres. The objective of this study was to evaluate the performance of the PTS, TRISS and ICISS scales in predicting the survival of the children in the study and to make a comparative evaluation of the outcome of the patients concerning a reference centre. Materials &amp; methods: Analytical study of a retrospective cohort of children under 18 years of age with injuries treated at a Colombian major trauma centre, between 2011 and 2019. The main outcome was 30-day mortality. The performance of the scales was evaluated through discrimination (AUROC) and calibration. A new predictive model was developed with adjustments to the TRISS and ICISS scale and validated using bootstrapping. Results: 1047 subjects were recruited into the study. The median age was 12 years, 73.7% were men, the most frequent type of trauma was closed with 66%, and the most frequent mechanism was traffic accidents with 31.7%. Mortality was 5.9%, 61.3% of those killed were between 15 and 17 years old, and 73.7% of them died from assault, 96.4% of which were with a firearm. The discrimination of PTS was 0.93 and showed good calibration. The performance of the new predictive models was good for TRISS and ICISS with an AUROC of 0.97 and 0.95 respectively. The statistics and calibration graph showed a good fit between the results observed and predicted by the model. Conclusion: Trauma from violence was an important cause of mortality in the children in the study. The PTS scale performed well in predicting the survival of the injured children in the study. The new predictive models developed with the TRISS and ICISS scales had good predictive performance and their internal validation also showed favorable results.No

POCUS to confirm cardiac arrest in inferior limb trauma

History: A 79-year-old female was admitted to a quaternary care facility after being struck by a bus. Clinical Finding: Upon arrival, the patient presented with a Glasgow Coma Scale score of 3T, an inaudible arterial pressure as determined by a device, and a pulseless femoral artery. A primary evaluation confirmed a degloving lesion on the lower left limb, beginning approximately one-third proximally, with active bleeding. Investigation Result: Suspected cardiorespiratory arrest was considered due to the inaudible arterial pressure and pulseless carotid artery. Instead of proceeding with chest compressions, the medical team used Point of Care Ultrasonography (POCUS) to confirm cardiac arrest. However, POCUS showed functional myocardial contractility with low output. Diagnosis: POCUS confirmed a false diagnosis of cardiac arrest due to intense hemorrhage from the traumatic lesion. Therapy &amp; Progression: A transfusion protocol was initiated for hemodynamic resuscitation. After stabilization, the patient underwent limb amputation in the affected area. Comment: Cardiac arrest in trauma patients carries a higher mortality rate when compared to non-traumatic cases, with the most common rhythms being asystole and pulseless electrical activity. Therefore, a better understanding of pathophysiology is crucial to improve survival, as each presentation requires a specific approach. Although not yet scientifically proven due to challenges in standardizing tests, POCUS appears to be an effective tool in reducing trauma-related mortality. In this case, its use was crucial for identifying myocardial contractions and ensuring proper stabilization instead of initiating CPR. References: ÁvilaReyes Diana et al, "Point-of-care ultrasound in cardiorespiratory arrest: narrative review," The ultrasound journal, vol. 13, 146, 2 Dec 2021. Lee, Linda, and Jeanne M DeCara, "Point-of-Care Ultrasound," Current cardiology reports, vol. 22, 149, 17 Sep 2020. Image: degloving lesionNo

Motorcyclists fatal trauma in Brazil – Main characteristics from victims in the first decade of action for road safety

Introduction Motorcycles are one of the most notorious types of transport when it comes to high road crashes and casualty indexes in the field of study of road safety. More than half of global deaths in road crashes included motorcyclists, cyclists and pedestrians in 2018. Motorcycles lead the rankings in terms of road traffic deaths since their consolidation as one of the main means of transport of modern society. In Brazil, the proportion of accidents involving motorcyclists has grown from 1996 to 2010, and they represent the majority of fatal victims in the last decade. This scenario configures an obstacle for public health and trauma prevention, inducing the conception of numerous studies focusing on rectifying the deficiencies within the Brazilian national road safety system through legislative reforms, such as lowering the BAC (blood alcohol content) tolerance, speed limit reduction, mandatory use of helmets, improvement of post-crash care, etc. These aspects motivate this research to investigate road traffic deaths of motorcycle occupants in Brazil through the adjustment of a classification model aiming to inspect personal attributes of the victims and indicate the importance and significance of each variable considered. Material and Methods This model utilizes the Binary Logistic Regression method to predict a class for each analyzed victim (classifying them as either motorcycle occupant or not) based on the predictive features extracted from the Brazilian Ministry of Health database, including age, ethnicity, sex, level of education, marital status and place of death. The fitting of the model was achieved through a combination of Hold-out and Cross Validation sampling techniques, and the odd ratios were obtained from each variable to evaluate the likelihood of being a motorcycle occupant victim based on their category. Results and Conclusions The study shows that male, mixed race young adults are the individuals most affected by motorcycle related deaths.No

Determinants and conditions contributing to fatal traffic accidents in Campinas

Introduction: Every year more than 1.3 million individuals worldwide die due to traffic accidents. Brazil has held the third position in the ranking of countries with the highest number of traffic-related fatalities since 2015. For this reason, the Intersectoral Committee for the Analysis of Traffic Accident Deaths in the city of Campinas began its activities in 2014 and represents a group formed by healthcare, security and logistics sectors in the city to analyze the cases of death. Objectives: To comprehend the determinants and conditions contributing to fatal traffic accidents in Campinas. Methods: Descriptive analysis of traffic accidents and risky behaviors of accidents that resulted in fatalities in Campinas in 2020. The analyzed factors will include: type of road, time of the accident, day of the week, gender, age, city of origin, type of vehicle, and risky behaviors. The information was obtained through the database provided by the Respect for Life Program (PRV) and the Mortality Information System (SIM) and investigated by the Department of Surveillance and Health (DEVISA). Results: In 2020 Campinas had 124 deaths from traffic accidents, four were excluded due to lack of supporting information. Most accidents occurred on highways (51%), at nighttime (45.8%), on Sundays (20%), and most victims were male (86.2%), aged 40-59 (34%), and residents of the municipality itself (61%). The majority of accidents involved motorcycles (53.7%). Alcohol or drug consumption (26.1%) and speeding (23.9%) were the major risk factors. Conclusion: It is important to analyze and produce information to support and establish priorities when planning programs to prevent trauma. In that way, increase awareness among young males in Campinas and neighboring cities, about the dangers of alcohol and speeding on highways. Additionally, measures to enhance road safety, especially during nighttime, should be promoted to ensure the protection of all individuals.No.

Management of traumatic blunt chest Injuries due to motor vehicle collisions in a community-based hospital

Introduction: The aetiology and pattern of blunt chest trauma vary according to the mechanism and severity of the injury. Motor Vehicle Collisions (MVCs) account for the majority of blunt thoracic trauma. The rapidly developing Middle Eastern countries have a higher incidence of MVC-related injuries, which is mainly attributed to the high motorization rate (1). We aimed to evaluate the clinical presentation, severity, and outcome of admitted blunt chest trauma patients due to MVCs at our community-based hospital. Patients and methods: We retrospectively collected data of all patients who were admitted to our community-based hospital with blunt chest trauma due to MVCs from December 2014 through January 2017. The Injury details of all blunt chest trauma patients were retrieved from Al Ain hospital trauma registry. Results: During the study period, 669 patients were admitted to the hospital with blunt chest trauma. MVC was the cause of trauma in 436 (65.2%) patients, of these, 366 (83.9%) were men and 70 (16.1%) were women. The mean patient age (range) was 32.6 (1–95) years. Care collision was the most common mechanism in 331 patients (75.9%), followed by pedestrian injury in 69 (15.8%) patients. Lung contusion was the most common chest injury in 164 (37.6%) patients. Lower limb injury was the comments extra-thoracic injury in 135 (31%) patients (Table 1).The mean (range) ISS was 11.7 (1-45), NISS was 13.6 (1-50), and GCS mean (range) was14.2 (3-15). Eleven patient died (all over mortality was2.5%). Conclusions: Motor vehicle collisions are the commonest cause for blunt chest injuries admission to our hospital. Specific injury prevention programs should be implemented to minimize the chest injuries related to motor vehicle collisions References: El-Menyar A, Abdelrahman H, Al-Hassani A, et al. Clinical Presentation and Time-Based Mortality in Patients With Chest Injuries Associated With Road Traffic Accidents. Arch Trauma Res. 2016 Jan 23;5(1):e31888. No

Ass. Prof.

Blunt cerebrovascular injuries and the association with cervical spine injuries: A danish register-based cohort study

Introduction: Trauma to the neck and spine is common in the Emergency Department (ED). Blunt cerebrovascular injuries (BCVI), rare but alarming, involve damage to neck vessels, often resulting from trauma to the head, neck, or chest. Undetected BCVI carries high mortality and morbidity rates. Motor vehicle accidents (MVAs) are a primary cause, with a significant link to cervical spine injuries (CSI). Methods: A nationwide study in Denmark included trauma patients transported to Level 1 Trauma Centers between 2017-2021. Data from the National Trauma Database identified CSI and BCVI cases using AIS codes. The study aimed to examine the relationship between BCVI and CSI, focusing on specific CSI types and related factors. Odds ratios (OR) with 95% confidence intervals were computed. Results: Among 12,638 patients, 498 (4%) had CSI due to blunt trauma, and 57 (0.5%) had BCVI. The overall BCVI rate among CSIs was 5.6%. A significant association between CSI and BCVI (p = 0.013) was found, with a strong predictive value (OR 24.9, 95% CI 14.7 - 42.2). Factors associated with BCVI in cervical spine injury patients included older age, higher Injury Severity Score, lower Glasgow Coma Scale, lower systolic blood pressure, and male gender. Conclusion: This nationwide study in Denmark highlights a significant link between cervical spine injuries and blunt cerebrovascular injuries in trauma patients at Level 1 Trauma Centers. It emphasizes the crucial need for early BCVI detection, underscoring the importance of vigilance and comprehensive management to prevent severe neurological deficits and fatalities in head and neck trauma.The project was funded by Civilstyrelsen (Offerfonden) under the Ministry of Justice grant number 22-610-0166 and by Torben &amp; Alice Frimodts Fond. The data collection was approved by the local ethical committee and the office for research in region Midt (DK) 1-45-70-19-23.

Poster session 11
Trauma and Emergency | Miscellaneous: Session 4

Appointment

Chairs

Topic

Programme

Poster session 11Trauma and Emergency | Miscellaneous: Session 4

Appointment

Chairs

Topic

Programme

Poster session 11
Trauma and Emergency | Miscellaneous: Session 4