{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:29:33Z","timestamp":1791512973902,"version":"4.3.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T00:00:00Z","timestamp":1686096000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Non-iatrogenic aerodigestive injuries are infrequent but potentially fatal. We hypothesize that advances in management and adoption of innovative therapies resulted in improved survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Trauma registry review at a university Level 1 center from 2000 to 2020 that identified adults with aerodigestive injuries requiring operative or endoluminal intervention. Demographics, injuries, operations, and outcomes were abstracted. Univariate analysis was performed, P &lt; .05 was statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>95 patients had 105 injuries: 68 tracheal and 37 esophageal (including 10 combined). Mean age 30.9 (\u00b1 14), 87.4% male, 82.1% penetrating, and 28.4% with vascular injuries. Median ISS, chest AIS, admission BP, Shock Index, and lactate were 26 (16-34), 4 (3-4), 132 (113-149) mmHg, .8 (.7-1.1), and 3.1 (2.4-5.6) mmol\/L, respectively . There were 46 cervical and 22 thoracic airway injuries; 5 patients in extremis required preoperative ECMO. 66 airway injuries were surgically repaired and 2 definitively managed with endobronchial stents. There were 24 cervical, 11 thoracic, 2 abdominal esophageal injuries\u2014all repaired surgically. Combined tracheoesophageal injuries were individually managed and buttressed. 4 airway complications were successfully managed, and 11 esophageal complications managed conservatively, stented, or resected. Mortality was 9.6%, half from intraoperative hemorrhage. Specific mortality: tracheobronchial 8.8%, esophageal 10.8%, and combined 20%. Mortality was significantly associated with higher ISS (P = .01), vascular injury (P = .007), blunt mechanism (P = .01), bronchial injury (P = .01), and years 2000-2010 (P = .03), but not combined tracheobronchial injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mortality is associated with several variables, including vascular trauma and years 2000-2010. The use of ECMO and endoluminal stents in highly selected patients and institutional experience may account for 97.8% survival over the past decade.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348231180917","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T06:47:07Z","timestamp":1686120427000},"page":"5982-5987","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Operative Management of Aerodigestive Injuries: Improved Survival Over two Decades"],"prefix":"10.1177","volume":"89","author":[{"given":"Patrick F.","family":"Walker","sequence":"first","affiliation":[{"name":"R Adams Cowley Shock Trauma Center, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel M.","family":"Galvagno","sequence":"additional","affiliation":[{"name":"RA Cowley Shock Trauma Center, University of Maryland, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashutosh","family":"Sachdeva","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David V.","family":"Feliciano","sequence":"additional","affiliation":[{"name":"RA Cowley Shock Trauma Center, University of Maryland, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Scalea","sequence":"additional","affiliation":[{"name":"RA Cowley Shock Trauma Center, University of Maryland, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James V.","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"RA Cowley Shock Trauma Center, University of Maryland, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,7]]},"reference":[{"key":"bibr1-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1136\/thx.27.2.188"},{"key":"bibr2-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)02453-X"},{"key":"bibr3-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(02)00591-2"},{"key":"bibr4-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(97)01001-1"},{"key":"bibr5-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1186\/1749-8090-9-117"},{"key":"bibr6-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)60347-5"},{"key":"bibr7-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1177\/000313481307900230"},{"key":"bibr8-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)64456-6"},{"key":"bibr9-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198006000-00007"},{"key":"bibr10-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198508000-00009"},{"key":"bibr11-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200102000-00015"},{"key":"bibr12-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1186\/1749-8090-5-46"},{"key":"bibr13-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(77)90313-0"},{"key":"bibr14-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4760"},{"key":"bibr15-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(85)90414-3"},{"key":"bibr16-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)60387-6"},{"key":"bibr17-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900167"},{"key":"bibr18-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000772"},{"key":"bibr19-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-015-4050-3"},{"key":"bibr20-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.09.002"},{"issue":"3","key":"bibr21-00031348231180917","first-page":"195","volume":"79","author":"Levy RD","year":"1997","journal-title":"Ann Roy Coll Surg"},{"key":"bibr22-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.07.018"},{"key":"bibr23-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-018-4480-6"},{"key":"bibr24-00031348231180917","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002841"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348231180917","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348231180917","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348231180917","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:38:08Z","timestamp":1777379888000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348231180917"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,7]]},"references-count":24,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1177\/00031348231180917"],"URL":"https:\/\/doi.org\/10.1177\/00031348231180917","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,7]]}}}