Aortic transection: demographics, treatment and outcomes in Victoria, Australia

Abstract

Aortic transection was generally secondary to traffic-related injury affecting young men, with a mortality rate of over 90%. There has been a trend towards endovascular treatment over open repair in Victorian trauma centres.

Analysis of risk factors for death after blunt traumatic rupture of the thoracic aorta

“…The in-hospital mortality in our study was 31.4%, which is comparable with the mortality observed by others 4 7. However, the surgical procedure contributed to improved survival after thoracic endovascular aortic repair (TEVAR) in comparison with the open procedure (58.8% vs 9.1%).…”

“…However, the HR for early death after TAR was only 1.05 suggesting that age has no major impact on the outcome. Moreover, the mean age in our cohort was evidently higher compared with others (47 vs 38 years) although the mortality rate in our study was lower 4. As with previous reports,5 19 21 we identified unstable haemodynamic condition on hospital admission as a risk factor for in-hospital mortality (HR 16.11, p<0.001).…”

“…A pedestrian struck by a car was a marginally significant determinant of prehospital mortality (p=0.05). However, the risk of aortic injury is greater in occupants of motor vehicle crashes, which is the leading cause of aortic rupture in our own (49.4%) and other studies with a prevalence between 50% and 57% 3 4 6. We found drivers to be affected threefold as much as non-drivers, but we are not able to compare safety belt users versus non-users, airbag versus non-airbag and side impact versus frontal collision.…”

Five-year experience with the peri-operative goal directed management for surgical repair of traumatic aortic injury in the eastern province, Saudi Arabia

“…Our study shows that the risk of TAI is more prevalent among the victims of motor vehicle crashes (93.2%) than in other studies (49.4-57%). [ 3 4 11 12 ] In similar to others,[ 3 ] we found drivers to be affected twenty-fold as much as non-drivers. The associated injuries were present in 39 patients (88.6%) including left hemopneumothorax (95.4%), pulmonary contusions (88.6%), rib fractures (90.9%), traumatic brain injury (20.5%), splenic injury (6.8%), hepatic injury (9.1%) and spinal injury (79.5%) respectively.…”

“…[ 2 ] Despite major advances in pre-hospital life support, nearly 40-90% of patients presenting with traumatic rupture of the thoracic aorta die at the scene, whereas 10-60% survive to the emergency department (ED) with an aortic isthmus injury and an in-hospital mortality of 31.4-66% respectively. [ 3 4 5 ] Survivors to the ED usually have lacerations of part or all of the aortic circumference with the pseudo-aneurysm formation in 60% of cases. [ 6 ]…”