title: Predicting outcomes using the National Trauma Data Bank: optimum management of traumatic blunt carotid and blunt thoracic injury.
abstract: BACKGROUND
  We used the National Trauma Data Bank (NTDB) to examine the incidence of blunt thoracic and carotid trauma nationally and survival outcomes based on treatment approach.
  
  
  METHODS
  All vascular traumas were identified from the 2008 NTDB. International Classification of Diseases, 9th Revision (ICD-9) diagnosis coding was used to identify 178 blunt thoracic aortic injuries and 313 traumatic blunt carotid injuries.
  
  
  RESULTS
  In all, 2089 vascular traumas were identified. Patients with blunt thoracic trauma within the highest injury severity score (ISS) range (61-75) had a significant survival advantage when observation was compared with endovascular management (P < .05). In the carotid trauma cohort, those with the highest ISS range (61-75) had a significant survival advantage with open surgery compared with observation (P < .01).
  
  
  CONCLUSIONS
  Patients with traumatic blunt thoracic injury and an ISS > 61 appeared to benefit from endovascular approaches compared with open management. Patients with blunt carotid trauma and an ISS > 61 appeared to benefit from open surgical management.
authors.affiliation: University of Texas at Houston, TX, USA.
authors.forename: Anahita
authors.initials: A
authors.lastname: Dua
authors.forename: Sapan S
authors.initials: SS
authors.lastname: Desai
authors.forename: SreyRam
authors.initials: S
authors.lastname: Kuy
authors.forename: Bhavin
authors.initials: B
authors.lastname: Patel
authors.forename: Arshish
authors.initials: A
authors.lastname: Dua
authors.forename: Pathik J
authors.initials: PJ
authors.lastname: Desai
authors.forename: Matthew
authors.initials: M
authors.lastname: Darlow
authors.forename: Jay
authors.initials: J
authors.lastname: Shirgavi
authors.forename: Kristofer
authors.initials: K
authors.lastname: Charlton-Ouw
authors.forename: Cynthia
authors.initials: C
authors.lastname: Shortell
mesh_terms: D020212:Carotid Artery Injuries / Q000401:mortality / Q000601:surgery*; D016208:Databases, Factual; D057510:Endovascular Procedures; D006801:Humans; D013898:Thoracic Injuries / Q000401:mortality / Q000601:surgery*; D014481:United States; D014949:Wounds, Nonpenetrating / Q000401:mortality / Q000601:surgery*