Thoracic aortic injury in Japan--nationwide retrospective cohort study.
BACKGROUND
The epidemiology of traumatic thoracic aortic injury has not been reported in many countries, so we investigated the current trends in Japan.


RESULTS
Patients with traumatic thoracic aortic injury from July 2007 to March 2013 were identified using a Japanese nationwide administrative database, the Diagnosis Procedure Combination inpatient database. The trends in crude in-hospital mortality and proportion of endovascular repair use among patients with repair were evaluated over time. A total of 617 incident cases of thoracic aortic injury were identified at 234 hospitals, and categorized into endovascular repair (n=126), open repair (n=76), and non-repair (n=415) groups. The in-hospital mortality rate for each of these groups was 5.6%, 15.8%, and 45.3%, respectively. The in-hospital survival rate was higher in the endovascular repair group than in the open repair group (log-rank χ(2)=4.9; P=0.03). Although the crude in-hospital mortality did not change significantly during the study period (Mantel-Haenszel trend test, P=0.10), the proportion of endovascular repair use among all repair cases increased significantly (P<0.001).


CONCLUSIONS
The results of the present nationwide study suggest that the endovascular approach to treatment of thoracic aortic injury in Japan gained in popularity from 2007 to 2012.
Department of Clinical Epidemiology and Health Economics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo; Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo. t-tagami@nms.ac.jp
Takashi
T
Tagami
Hiroki
H
Matsui
Hiromasa
H
Horiguchi
Kiyohide
K
Fushimi
Hideo
H
Yasunaga
D000046:Academic Medical Centers / Q000706:statistics & numerical data; D001013:Aorta, Thoracic / Q000293:injuries* / Q000601:surgery; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002544:Cerebral Infarction / Q000453:epidemiology; D016208:Databases, Factual; D057510:Endovascular Procedures / Q000706:statistics & numerical data / Q000639:trends; D015199:Extracorporeal Membrane Oxygenation / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009104:Multiple Trauma / Q000453:epidemiology; D012189:Retrospective Studies; D012709:Serum Albumin / Q000627:therapeutic use; D014656:Vascular Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology / Q000628:therapy
D012709:Serum Albumin