A systematic review of blunt abdominal aortic injury and analysis of predictors for death

Abstract

At present, there are few studies on blunt abdominal aortic injury (BAAI), and most of them are case reports. Little is known about this disease. So, a systematic review was conducted through extensive search of major databases. All literature that provided individual (non-identifiable) data for BAAI patients could be included without being limited by study design. Additionally, regression analyses of predictors for death after BAAI were conducted. The search resulted in 2,099 hits, and 102 case reports and 1 conference abstract included in the review then. After assessment using the Joanna Briggs Institute checklist, no low-quality studies were found. A total of 133 patients were included, with a median age of 34 and 73.7% being 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%. The following are the predictors for death after BAAI identified through multivariate regression analyses: 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). In conclusion, this study provides a detailed quantitative summary of the characteristics of the clinical manifestations, diagnosis, treatment, and prognosis of BAAI, a deadly traumatic disease, and indicates that the three variables above are risk factors for death.