Background Studies on the mortality of blunt abdominal aortic injury (BAAI) are rare, and the rates reported by them vary widely. We aimed to quantitatively analyze the data retrieved and reveal the hospital mortality of this disease more precisely. Methods Published studies were searched on Excerpta Medica Database (Embase), PubMed, Web of Science (WOS) and Cochrane Library without date restriction. We set the overall hospital mortality (OHM) and its 95% confidence interval (CI) of BAAI patients as the primary outcome measure. English references with data that met the selection criteria were included. The quality of all included studies was assessed by the Joanna Briggs Institute (JBI) checklist and the American Agency for Health Care Quality and Research’s (AHQR) cross-sectional study quality evaluation items. After data extraction, a meta-analysis was performed using the metaprop command of joint the Freeman-Tukey double arcsine transformation of data in Stata 16 software. Heterogeneity was assessed and reported as a percentage using the I² index value and as a P value using the Cochrane Q test. And various methods were used to find out the source of heterogeneity and analyze the sensitivity of the computation model. Results Of 2,147 references screened, 5 studies that involve 1,593 patients were included because of meeting the selection criteria. There were no low-quality references after assessment. There was 1 study that only included 16 juvenile BAAI patients was excluded from the meta-analysis of the primary outcome measure due to great heterogeneity. Because of low heterogeneity (I2 = 47.6%, P = 0.126 for Q test) after analysis using a random effects model, pooling the ESs of remaining four references using a fixed effects model yielded an OHM = 28.8% (95% CI, 26.5%-31.1%). The good stability of the model was verified by checking calculation. Egger’s test yielded P = 0.339, which shows the low publication bias of the model. In addition, we also performed meta-analyses and obtained the pooled hospital mortality of operation [13.5% (95%CI, 8.0%-20.0%)] and the pooled hospital mortality of non-operation [28.4% (95%CI, 25.9%-31.0%)] of BAAI, respectively. Conclusions BAAI has an OHM of 28.8%. This serious disease deserves more attention and research.

Background Studies on the mortality of blunt abdominal aortic injury (BAAI) are rare and have yielded inconsistent results. In the present study, we aimed to quantitatively analyse the retrieved data to more accurately determine the hospital mortality of BAAI. Methods The Excerpta Medica Database, PubMed, Web of Science and Cochrane Library databases were searched to identify relevant publications without date restrictions. The overall hospital mortality (OHM) of BAAI patients was set as the primary outcome measure. English publications with data that met the selection criteria were included. The quality of all included studies was assessed by the Joanna Briggs Institute checklist and the American Agency for Health Care Quality and Research’s cross-sectional study quality evaluation items. After data extraction, a meta-analysis of the Freeman–Tukey double arcsine transformation of data was performed using the Metaprop command in Stata 16 software. Heterogeneity was assessed and reported as a percentage using the I2 index value and as a P value using the Cochrane Q test. Various methods were used to determine the sources of heterogeneity and to analyse the sensitivity of the computation model. Results Of the 2147 references screened, 5 studies that involved 1593 patients met the selection criteria and were included. There were no low-quality references after assessment. One study that only included 16 juvenile BAAI patients was excluded from the meta-analysis of the primary outcome measure due to high heterogeneity. Due to the low heterogeneity (I2 = 47.6%, P = 0.126 for Q test) that was observed after using the random effects model, the fixed model was subsequently used to pool the effect sizes of the remaining four studies, thus yielding an OHM of 28.8% [95% confidence interval (CI) 26.5–31.1%]. The stability of the model was verified by sensitivity analysis, and Egger’s test (P = 0.339) indicated a low level of publication bias. In addition, we also performed meta-analyses and obtained a pooled hospital mortality of operation (13.5%, 95% CI 8.0–20.0%), a pooled hospital mortality of non-operation (28.4%, 95% CI 25.9–31.0%), and a pooled rate of aortic rupture (12.2%, 95% CI 7.0–18.5%) of BAAI. Conclusions The present study indicated that BAAI has an OHM of 28.8%, indicating that this disease deserves more attention and research.

Background Blunt abdominal aortic injury (BAAI) is characterized by diverse clinical manifestations, evaluations, and treatment criteria, while very high mortality. At present, there are few studies on BAAI, and most of them are case reports. Methods By including available case reports world widely, a systematic review regarding the data of BAAI patients in characteristics, treatments, and outcomes was performed. And regression analysis of predictors for death after BAAI was conducted. Results The systematic search of Excerpta Medica Database, PubMed, Web of Science and Cochrane Library resulted in 2,099 hits. There were 102 case reports and 1 conference abstract met the inclusion criteria and were eligible for analysis. After assessment using the Joanna Briggs Institute (JBI) checklist, no low-quality studies were found. Then the data of 133 BAAI patients were concluded and analyzed. The median age of these patients was 34, and there were 98 (73.7%) males. Their most common clinical manifestation was pain (65.6%). The most common severity of aortic lesion was grade A (intimal tear or intramural hematoma) (46.9%), and the most common location of aortic lesion was zone III (infrarenal aorta) (88.3%). The overall mortality after BAAI was 15.3%. On multivariable regression analysis, the risk of death after BAAI was increased in patients with lower limb ischemia [relative risk (RR), 7.137; 95% confidence interval (CI), 1.154–44.161], cardiopulmonary arrest (RR, 10.250; 95% CI, 1.452–72.344), and injuries to other parts (other than abdomen and lumbar spine) of body (RR, 2.593; 95% CI, 1.189–5.655). Then on subgroup analysis, patients with BAAI in the presence of lower limb ischemia or injuries to other parts of body, whether undergoing primary or secondary operation, had lower mortality than those who underwent conservative observation (P < 0.05), but the mortality of BAAI patients who presented with cardiopulmonary arrest would not be affected by different treatment modalities (P = 1.000). Conclusions BAAI is a fatal disease. The above three variables are risk factors for death after BAAI. Operation (in any form) to BAAI patients who have these risk factors may reduce their mortality risks.