Gunshot wounds to the thoracic aorta in the '90s: only prevention will make a difference.
The clinical experience with gunshot injuries to the thoracic aorta at a large urban trauma center was reviewed. Of 1961 patients admitted with gunshot wounds to the chest, 20 sustained injuries to the thoracic aorta. Mortality occurred in 17 patients (85%), all of whom were hypotensive or moribund upon admission. The three patients (15%) presenting with a systolic blood pressure above 100 mm Hg survived; only one of these underwent surgery during the acute period. Only two patients were stable enough for aortography. Advances in the management of critically injured patients have not improved the outcome with this lethal injury.
Cornwell
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EE
Department of Surgery, Los Angeles County + University of Southern California Medical Center 90033-4525, USA.
Kennedy
F
F
Berne
T V
TV
Asensio
J A
JA
Demetriades
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D
D000293:Adolescent; D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000293:injuries* / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001018:Aortic Diseases / Q000601:surgery; D004937:Esophageal Fistula / Q000601:surgery; D005260:Female; D005402:Fistula / Q000601:surgery; D006801:Humans; D007022:Hypotension / Q000453:epidemiology; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D012189:Retrospective Studies; D015996:Survival Rate; D013898:Thoracic Injuries / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control / Q000601:surgery; D013908:Thoracotomy; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control / Q000601:surgery