Delay of computed tomography is associated with poor outcome in patients with blunt traumatic aortic injury a nationwide observational study in Japan

Katayama, Yusuke; Kitamura, Tetsuhisa; Hirose, Tomoya; Kiguchi, Takeyuki; Matsuyama, Tasuku; Sado, Junya; Kiyohara, Kosuke; Izawa, Junichi; Tachino, Jotaro; Ebihara, Takeshi; Yoshiya, Kazuhisa; Nakagawa, Yuko; Shimazu, Takeshi

doi:https://doi.org/10.1097/MD.0000000000012112

Delay of computed tomography is associated with poor outcome in patients with blunt traumatic aortic injury a nationwide observational study in Japan

Katayama, Yusuke; Kitamura, Tetsuhisa; Hirose, Tomoya et al.

Medicine (United States), 2018, 97(35), e12112

アクセス数:1,607件（2025-08-15 06:48 集計）

固定URL: https://hdl.handle.net/11094/78393

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タイトル	Delay of computed tomography is associated with poor outcome in patients with blunt traumatic aortic injury a nationwide observational study in Japan
著者	NRID 1000050747144 1000050747144 ORCID 0000-0003-2585-4259 0000-0003-2585-4259 researchmap permalink orion2013 orion2013 Scopus Author ID 56470235000 56470235000 著者名 Katayama, Yusuke
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 著者名 Kitamura, Tetsuhisa
	NRID 1000070597509 1000070597509 researchmap permalink tomoyahirose tomoyahirose Scopus Author ID 41861413300 41861413300 著者名 Hirose, Tomoya
	NRID 1000030724380 1000030724380 著者名 Kiguchi, Takeyuki
	NRID 1000050829025 1000050829025 著者名 Matsuyama, Tasuku
	著者名 Sado, Junya
	NRID 1000080581834 1000080581834 著者名 Kiyohara, Kosuke
	著者名 Izawa, Junichi
	NRID 1000050747152 1000050747152 ORCID 0000-0002-0423-7713 0000-0002-0423-7713 researchmap permalink jotarotachino jotarotachino Scopus Author ID 57203882578 57203882578 著者名 Tachino, Jotaro
	NRID 1000010813975 1000010813975 ORCID 0000-0003-4101-0419 0000-0003-4101-0419 researchmap permalink ebihara830 ebihara830 著者名 Ebihara, Takeshi
	NRID 1000040379201 1000040379201 著者名 Yoshiya, Kazuhisa
	NRID 1000040362719 1000040362719 著者名 Nakagawa, Yuko
	NRID 1000050196474 1000050196474 著者名 Shimazu, Takeshi
キーワード等	Aortic injury
	Blunt trauma
	Computed tomography
	Prognosis
	Timing
内容	Katayama, Yusuke MD, PhD; Kitamura, Tetsuhisa MD, DrPHb; Hirose, Tomoya MD, PhDa,c; Kiguchi, Takeyuki MD, PhD; Matsuyama, Tasuku MD, PhDe; Sado, Junya PhDb; Kiyohara, Kosuke DrPH; Izawa, Junichi MD, DrPH; Tachino, Jotaro MD; Ebihara, Takeshi MD; Yoshiya, Kazuhisa MD, PhD; Nakagawa, Yuko MD, PhD; Shimazu, Takeshi MD, PhDa Delay of computed tomography is associated with poor outcome in patients with blunt traumatic aortic injury, Medicine: August 2018 - Volume 97 - Issue 35 - p e12112 doi: 10.1097/MD.0000000000012112
抄録	According to guidelines from the Eastern Association for the Surgery of Trauma, computed tomography (CT) with intravenous contrast is strongly recommended to diagnose clinically significant blunt traumatic aortic injury (BTAI). However, it remains unclear whether the timing of CT scanning is associated with the prognosis of BTAI patients. We extracted data on emergency patients who suffered a BTAI in the chest and/or the abdomen from 2004 to 2015 from the Japanese Trauma Data Bank, a nationwide trauma registry. The primary outcome was death in the emergency department (ED) and secondary outcome was discharge to death. In addition, we assessed the relationship between death in the ED and the timing of CT scanning by shock status in subgroup analysis. We divided these patients into the tertile groups of early (26minutes), middle (27- 40minutes), and late (≥41minutes) phases based on the time interval from hospital arrival to start of first CT scanning, and assessed death of BTAI patients in the ED by CT scanning time with the use of a multivariable logistic regression model. In total, 421 patients who suffered BTAI in the chest and/or the abdomen were eligible for our analysis. The proportion of patients dying at hospital admission was 7.7% (11/142) in the early group, 11.1% (15/135) in the middle group, and 17.6% (25/144) in the late group. In a multivariable logistic regression adjusted for confounding factors, the adjusted odds ratio (AOR) of death in the ED was 1.833 (95% confidence interval [CI]: 0.601-5.590, P=.287) in the middle group and 2.832 (95% CI: 1.007-7.960, P=.048) in the late group compared with the early group. Compared with the early group, the late group tended to have a higher rate of discharge to death (AOR: 1.438, 95% CI: 0.735-2.813). In the patients with shock, the AOR was 3.292 (95% CI: 0.495-21.902) in the middle group and 6.039 (95% CI: 0.990-36.837) in the late group compared with the early group. This study revealed that a longer time interval from hospital arrival to CT scanning was associated with higher mortality in the ED in patients with BTAI.
出版者	Lippincott Williams and Wilkins
収録物名	Medicine (United States)
巻(号)	97(35)
ページ	e12112
刊行年月	2018-08
言語	英語
ハンドルURL	https://hdl.handle.net/11094/78393
PISSN	00257974
eISSN	15365964
NCID	AA12542695
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1097/MD.0000000000012112
関連情報 (isIdenticalTo)	PMID 30170440
アクセス権	open access
権利情報	© 2018 The Authors. Published by Wolters Kluwer Health, Inc. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	Medicine (United States). 2018, 97(35), p. e12112
DC.title	Delay of computed tomography is associated with poor outcome in patients with blunt traumatic aortic injury a nationwide observational study in Japan
DC.creator	Katayama, Yusuke
	Kitamura, Tetsuhisa
	Hirose, Tomoya
	Kiguchi, Takeyuki
	Matsuyama, Tasuku
	Sado, Junya
	Kiyohara, Kosuke
	Izawa, Junichi
	Tachino, Jotaro
	Ebihara, Takeshi
	Yoshiya, Kazuhisa
	Nakagawa, Yuko
	Shimazu, Takeshi
DC.publisher	Lippincott Williams and Wilkins
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2018-08
DC.identifier	https://doi.org/10.1097/MD.0000000000012112
DC.subject	Aortic injury
	Blunt trauma
	Computed tomography
	Prognosis
	Timing
DC.description	Katayama, Yusuke MD, PhD; Kitamura, Tetsuhisa MD, DrPHb; Hirose, Tomoya MD, PhDa,c; Kiguchi, Takeyuki MD, PhD; Matsuyama, Tasuku MD, PhDe; Sado, Junya PhDb; Kiyohara, Kosuke DrPH; Izawa, Junichi MD, DrPH; Tachino, Jotaro MD; Ebihara, Takeshi MD; Yoshiya, Kazuhisa MD, PhD; Nakagawa, Yuko MD, PhD; Shimazu, Takeshi MD, PhDa Delay of computed tomography is associated with poor outcome in patients with blunt traumatic aortic injury, Medicine: August 2018 - Volume 97 - Issue 35 - p e12112 doi: 10.1097/MD.0000000000012112
DCTERMS.abstract	According to guidelines from the Eastern Association for the Surgery of Trauma, computed tomography (CT) with intravenous contrast is strongly recommended to diagnose clinically significant blunt traumatic aortic injury (BTAI). However, it remains unclear whether the timing of CT scanning is associated with the prognosis of BTAI patients. We extracted data on emergency patients who suffered a BTAI in the chest and/or the abdomen from 2004 to 2015 from the Japanese Trauma Data Bank, a nationwide trauma registry. The primary outcome was death in the emergency department (ED) and secondary outcome was discharge to death. In addition, we assessed the relationship between death in the ED and the timing of CT scanning by shock status in subgroup analysis. We divided these patients into the tertile groups of early (26minutes), middle (27- 40minutes), and late (≥41minutes) phases based on the time interval from hospital arrival to start of first CT scanning, and assessed death of BTAI patients in the ED by CT scanning time with the use of a multivariable logistic regression model. In total, 421 patients who suffered BTAI in the chest and/or the abdomen were eligible for our analysis. The proportion of patients dying at hospital admission was 7.7% (11/142) in the early group, 11.1% (15/135) in the middle group, and 17.6% (25/144) in the late group. In a multivariable logistic regression adjusted for confounding factors, the adjusted odds ratio (AOR) of death in the ED was 1.833 (95% confidence interval [CI]: 0.601-5.590, P=.287) in the middle group and 2.832 (95% CI: 1.007-7.960, P=.048) in the late group compared with the early group. Compared with the early group, the late group tended to have a higher rate of discharge to death (AOR: 1.438, 95% CI: 0.735-2.813). In the patients with shock, the AOR was 3.292 (95% CI: 0.495-21.902) in the middle group and 6.039 (95% CI: 0.990-36.837) in the late group compared with the early group. This study revealed that a longer time interval from hospital arrival to CT scanning was associated with higher mortality in the ED in patients with BTAI.
DC.rights	© 2018 The Authors. Published by Wolters Kluwer Health, Inc. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
DC.format	78393
citation_title	Delay of computed tomography is associated with poor outcome in patients with blunt traumatic aortic injury a nationwide observational study in Japan
citation_author	Katayama, Yusuke
	Kitamura, Tetsuhisa
	Hirose, Tomoya
	Kiguchi, Takeyuki
	Matsuyama, Tasuku
	Sado, Junya
	Kiyohara, Kosuke
	Izawa, Junichi
	Tachino, Jotaro
	Ebihara, Takeshi
	Yoshiya, Kazuhisa
	Nakagawa, Yuko
	Shimazu, Takeshi
citation_publisher	Lippincott Williams and Wilkins
citation_language	英語
citation_date	2018-08
citation_journal_title	Medicine (United States)
citation_volume	97
citation_issue	35
citation_firstpage	e12112
citation_doi	https://doi.org/10.1097/MD.0000000000012112
citation_pmid	30170440
citation_public_url	https://hdl.handle.net/11094/78393

Delay of computed tomography is associated with poor outcome in patients with blunt traumatic aortic injury a nationwide observational study in Japan

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