Characteristics and in-hospital outcomes of pregnant trauma patients in Japan and the USA: A registry-based study.

Objective

Trauma is the leading non-obstetric cause of death during pregnancy, and there is an urgent need to improve its management in Japan and the USA. The present study described the patient characteristics, in-hospital management strategies, and clinical outcomes of pregnant trauma patients across two nations.

Methods

A retrospective registry-based study was conducted using the Japan Trauma Data Bank (JTDB) and National Trauma Data Bank (NTDB) between 2007 and 2018. Female trauma patients aged 15 to 49 years were included. Patient characteristics, in-hospital management, and clinical outcomes were described.

Results

A total of 156 (0.62%) and 3300 (0.23%) pregnant trauma patients were identified in JTDB and NTDB, respectively. Motor vehicle collision was the most common injury mechanism in both registries. Fall was the second leading mechanism (25.8%), while no gunshot wounds were observed in JTDB. Unintentional injuries were the leading cause of injury in both registries. The second leading cause of injury was self-inflicted injury in JTDB (15.5%) and assault in NTDB (13.5%). The median Injury Severity Score (ISS) was 9 in JTDB and 4 in NTDB. Computed tomography (CT) scan was performed on 60.9% of patients in JTDB and 28.7% of patients in NTDB, with the head being the most common region. Median hospital length of stay (LOS) was 6.5 days in JTDB and 2 days in NTDB. Mortality rates were 7.6% and 1.4% in JTDB and NTDB, respectively.

Conclusion

Notable differences in patient characteristics and in-hospital management strategies and clinical outcomes were observed between the two registries.