Outcome of blunt thoracic aortic injury in a level I trauma center: an 8-year review.
BACKGROUND
The purpose of this study was to evaluate our experience with blunt thoracic aortic injury and identify factors predictive of outcome.


METHODS
Hospital charts, trauma registry data, and autopsies of 64 patients with blunt thoracic aortic injury from 1988 to 1995 were reviewed.


RESULTS
Patients were identified and segregated based on admission physiology. Group 1 patients (n = 19) arrived in arrest. Group 2 patients (n = 10) arrived in shock with systolic BP 90. Group 3 patients (n = 35) arrived with systolic BP>90. All patients in groups 1 and 2 expired. Injury Severity Scores for nonsurvivors in group 3 (n = 12) were significantly higher than survivors. There were no significant differences when comparing time of injury to repair or arrival between groups, or in mortality or paralysis comparing repair techniques or clamp/bypass times. Double lumen endotracheal tubes caused significant operative delays compared to single lumen tubes.


CONCLUSIONS
Predictors of survivability were hemodynamic stability on arrival and lower Injury Severity Scores. In thoracic aortic injury patients arriving hemodynamically stable, Injury Severity Score correlated with mortality but not paralysis.
Frick
E J
EJ
Department of Surgery, Lehigh Valley Hospital, Allentown, Pennsylvania 18105-1556, USA.
Cipolle
M D
MD
Pasquale
M D
MD
Wasser
T E
TE
Rhodes
M
M
Singer
R L
RL
Nastasee
S A
SA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000293:injuries*; D002648:Child; D005260:Female; D006439:Hemodynamics; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012042:Registries; D016019:Survival Analysis; D014193:Trauma Centers; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000209:etiology / Q000401:mortality* / Q000628:therapy