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Hypertension in the Young Adult Trauma Population: Rethinking the Traditional "Incidentaloma".

Publication ,  Journal Article
Portelli Tremont, JN; Orleans, B; Strassle, PD; Dreesen, EB; Brownstein, MR
Published in: J Surg Res
December 2020

BACKGROUND: Hypertension (HTN) is a treatable and preventable risk factor for cardiovascular disease that is often overlooked in young adults. As a result, young patients with HTN may enter the health care system as a trauma without a preexisting diagnosis. The potential impact of HTN (diagnosed and undiagnosed) on trauma outcomes is not known. MATERIALS AND METHODS: Patients aged 18-39 y from the 2013-2017 North Carolina Trauma Registry were included. Patients were stratified as having no HTN, previously diagnosed HTN (PD-HTN), or newly diagnosed HTN (ND-HTN) during a trauma admission. Multivariable logistic and linear regression compared inpatient outcomes between patients with and without HTN, as well as ND-HTN and PD-HTN. RESULTS: Six percent of trauma patients were diagnosed with HTN (n = 1906; 14% ND-HTN). Those with HTN were more likely to have an inpatient complication (odds ratio [OR]: 1.65, 95% confidence interval [CI]: 1.32-2.07) and intensive care unit stay (OR: 1.28, 95% CI: 1.12-1.46) compared with patients without HTN. Compared with PD-HTN, those with ND-HTN were more likely to present with extreme injury. In addition, patients with ND-HTN had higher odds of inpatient complications (OR: 1.95, 95% CI: 1.18-3.22) and 30-d readmission (OR: 2.00, 95% CI: 0.95-4.20) after accounting for demographics and injury severity. CONCLUSIONS: More than 10% of young adult trauma patients with HTN are not diagnosed before admission. HTN appears to have a detrimental impact on patient outcomes, with newly diagnosed patients having the worst outcomes. Trauma may serve as an opportunity for the diagnosis and treatment of HTN in young adults. Future studies should assess the impact of intervention on trauma outcomes.

Duke Scholars

Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

December 2020

Volume

256

Start / End Page

439 / 448

Location

United States

Related Subject Headings

  • Young Adult
  • Wounds and Injuries
  • Treatment Outcome
  • Surgery
  • Risk Factors
  • Registries
  • Patient Readmission
  • Odds Ratio
  • North Carolina
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Portelli Tremont, J. N., Orleans, B., Strassle, P. D., Dreesen, E. B., & Brownstein, M. R. (2020). Hypertension in the Young Adult Trauma Population: Rethinking the Traditional "Incidentaloma". J Surg Res, 256, 439–448. https://doi.org/10.1016/j.jss.2020.07.013
Portelli Tremont, Jaclyn N., Brian Orleans, Paula D. Strassle, Elizabeth B. Dreesen, and Michelle R. Brownstein. “Hypertension in the Young Adult Trauma Population: Rethinking the Traditional "Incidentaloma".J Surg Res 256 (December 2020): 439–48. https://doi.org/10.1016/j.jss.2020.07.013.
Portelli Tremont JN, Orleans B, Strassle PD, Dreesen EB, Brownstein MR. Hypertension in the Young Adult Trauma Population: Rethinking the Traditional "Incidentaloma". J Surg Res. 2020 Dec;256:439–48.
Portelli Tremont, Jaclyn N., et al. “Hypertension in the Young Adult Trauma Population: Rethinking the Traditional "Incidentaloma".J Surg Res, vol. 256, Dec. 2020, pp. 439–48. Pubmed, doi:10.1016/j.jss.2020.07.013.
Portelli Tremont JN, Orleans B, Strassle PD, Dreesen EB, Brownstein MR. Hypertension in the Young Adult Trauma Population: Rethinking the Traditional "Incidentaloma". J Surg Res. 2020 Dec;256:439–448.
Journal cover image

Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

December 2020

Volume

256

Start / End Page

439 / 448

Location

United States

Related Subject Headings

  • Young Adult
  • Wounds and Injuries
  • Treatment Outcome
  • Surgery
  • Risk Factors
  • Registries
  • Patient Readmission
  • Odds Ratio
  • North Carolina
  • Male