title: Trends in clinical presentation, management, and mortality of blunt aortic traumatic injury over an 18-year period.
abstract: BACKGROUND
  The purpose of our study was to assess whether the trends in management of blunt thoracic aortic injury (BTAI) have changed its outcomes over the years.
  
  
  METHODS
  We reviewed data of 88 (0.3%) adult patients with BTAI from January 1993 to December 2010. Primary end points were trends in presentation and time to repair and early morbidity and mortality.
  
  
  RESULTS
  Of all, 63 (72%) patients with BTAI were male (age, 38 ± 17). The yearly distribution of cases and severity of associated injuries remain stable. Of all, 16 (21%) patients had no intervention, 47 (63%) underwent open repair, and 12 (16%) underwent endovascular treatment. The postoperative mortality has decreased from 29% to 9% and the time from presentation to repair has increased from 6 to 14 hours during the study period.
  
  
  CONCLUSIONS
  The incidence of BTAI remains stable with a reduction in postoperative mortality rate and an increasing number of delayed interventions over the past 18 years.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA.
authors.forename: Rafael D
authors.initials: RD
authors.lastname: Malgor
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Bilfinger
authors.forename: Jane
authors.initials: J
authors.lastname: McCormack
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Shapiro
authors.forename: Apostolos K
authors.initials: AK
authors.lastname: Tassiopoulos
mesh_terms: D000328:Adult; D001011:Aorta / Q000293:injuries* / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality / Q000639:trends*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality / Q000639:trends*; D057772:Vascular System Injuries / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D055815:Young Adult