Blunt Thoracic Aortic Injuries: An Autopsy Study
- 1 January 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Journal of Trauma and Acute Care Surgery
- Vol. 70 (1), 197-202
- https://doi.org/10.1097/ta.0b013e3181df68b3
Abstract
Objective: The objective of this study was to identify the incidence and patterns of thoracic aortic injuries in a series of blunt traumatic deaths and describe their associated injuries. Methods: All autopsies performed by the Los Angeles County Department of Coroner for blunt traumatic deaths in 2005 were retrospectively reviewed. Patients who had a traumatic thoracic aortic (TTA) injury were compared with the victims who did not have this injury for differences in baseline characteristics and patterns of associated injuries. Results: During the study period, 304 (35%) of 881 fatal victims of blunt trauma received by the Los Angeles County Department of Coroner underwent a full autopsy and were included in the analysis. The patients were on average aged 43 years ±21 years, 71% were men, and 39% had a positive blood alcohol screen. Motor vehicle collision was the most common mechanism of injury (50%), followed by pedestrian struck by auto (37%). A TTA injury was identified in 102 (34%) of the victims. The most common site of TTA injury was the isthmus and descending thoracic aorta, occurring in 67 fatalities (66% of the patients with TTA injuries). Patients with TTA injuries were significantly more likely to have other associated injuries: cardiac injury (44% vs. 25%, p = 0.001), hemothorax (86% vs. 56%, p < 0.001), rib fractures (86% vs. 72%, p = 0.006), and intra-abdominal injury (74% vs. 49%, p < 0.001) compared with patients without TTA injury. Patients with a TTA injury were significantly more likely to die at the scene (80% vs. 63%, p = 0.002). Conclusion: Thoracic aortic injuries occurred in fully one third of blunt traumatic fatalities, with the majority of deaths occurring at the scene. The risk for associated thoracic and intra-abdominal injuries is significantly increased in patients with thoracic aortic injuries.Keywords
This publication has 12 references indexed in Scilit:
- Blunt Traumatic Thoracic Aortic Injuries: Early or Delayed Repair—Results of an American Association for the Surgery of Trauma Prospective StudyThe Journal of Trauma and Acute Care Surgery, 2009
- Incidence and Crash Mechanisms of Aortic Injury During the Past DecadeThe Journal of Trauma and Acute Care Surgery, 2007
- Mechanisms of Aortic Blunt Rupture in Fatally Injured Front-Seat Passengers in Frontal Car CollisionsAmerican Journal of Forensic Medicine & Pathology, 2006
- Natural history of traumatic rupture of the thoracic aorta managed nonoperatively: a longitudinal analysisThe Annals of Thoracic Surgery, 2002
- Fatal Blunt Aortic Injuries: A Review of 242 Autopsy CasesJournal Of Trauma-Injury Infection and Critical Care, 2001
- The Epidemiology of Thoracic Aortic Injuries in PedestriansThe Journal of Trauma and Acute Care Surgery, 1998
- Routine Helical Computed Tomographic Evaluation of the Mediastinum in High-Risk Blunt Trauma PatientsArchives of Surgery, 1998
- CT aortography of thoracic aortic rupture.American Journal of Roentgenology, 1996
- AN AUTOPSY CASE REVIEW OF 142 NONPENETRATING (BLUNT) INJURIES OF THE AORTAJournal Of Trauma-Injury Infection and Critical Care, 1992
- Nonpenetrating Traumatic Injury of the AortaCirculation, 1958