title: Blunt aortic injury: risk factors and impact of surgical approaches.
abstract: OBJECTIVE
  This study reviews our 17-year experience of managing blunt traumatic aortic injury (BTAI).
  
  
  METHODS
  We analyzed information collected retrospectively from a tertiary trauma center.
  
  
  RESULTS
  Between October 1995 and June 2012, 88 patients (74 male and 14 female) with a mean age of 39.9 ± 17.9 years (range 15-79 years) with proven BTAI were enrolled in this study. Their GCS, ISS, and RTS scores were 12.9 ± 3.7, 29.2 ± 9.8, and 6.9 ± 1.4, respectively. Twenty-one (23.8 %) patients were managed non-operatively, 49 (55.7 %) with open surgical repair, and 18 (20.5 %) with endovascular repair. The in-hospital mortality rate was 17.1 % (15/81) and there were no deaths in the endovascular repair group. The mean follow-up period was 39.9 ± 44.2 months. The survivors of blunt aortic injury had lower ISS, RTS, TRISS, and serum creatinine level and lower rate of massive blood transfusion, shock, and intubation than the patients who died, despite higher rates of endovascular repair, hemoglobin, and GCS on presentation. The degree of aortic injury, different therapeutic options, GCS, shock presentation, and intubation on arrival all had significant impacts on outcome.
  
  
  CONCLUSIONS
  Shock, aortic injury severity, coexisting trauma severity, and different surgical approaches impact survival. Endovascular repair achieves a superior mid-term result and is a reasonable option for treating BTAI.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chiayi and Linkou Center, College of Medicine, Chang Gung University, 6.West Sec. Chiapu Road, Putzu City, Chiayi Hsien, 61636, Taiwan, Roc.
authors.forename: Chien-Chao
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chiayi and Linkou Center, College of Medicine, Chang Gung University, 6.West Sec. Chiapu Road, Putzu City, Chiayi Hsien, 61636, Taiwan, Roc.
authors.forename: Kuo-Sheng
authors.initials: KS
authors.lastname: Liu
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chiayi and Linkou Center, College of Medicine, Chang Gung University, 6.West Sec. Chiapu Road, Putzu City, Chiayi Hsien, 61636, Taiwan, Roc.
authors.forename: Huan-Wu
authors.initials: HW
authors.lastname: Chen
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chiayi and Linkou Center, College of Medicine, Chang Gung University, 6.West Sec. Chiapu Road, Putzu City, Chiayi Hsien, 61636, Taiwan, Roc. yaokuang@gmail.com.
authors.forename: Yao-Kuang
authors.initials: YK
authors.lastname: Huang
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chiayi and Linkou Center, College of Medicine, Chang Gung University, 6.West Sec. Chiapu Road, Putzu City, Chiayi Hsien, 61636, Taiwan, Roc.
authors.forename: Jaw-Ji
authors.initials: JJ
authors.lastname: Chu
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chiayi and Linkou Center, College of Medicine, Chang Gung University, 6.West Sec. Chiapu Road, Putzu City, Chiayi Hsien, 61636, Taiwan, Roc.
authors.forename: Feng-Chun
authors.initials: FC
authors.lastname: Tsai
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chiayi and Linkou Center, College of Medicine, Chang Gung University, 6.West Sec. Chiapu Road, Putzu City, Chiayi Hsien, 61636, Taiwan, Roc.
authors.forename: Pyng Jing
authors.initials: PJ
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001011:Aorta / Q000293:injuries*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data; D014949:Wounds, Nonpenetrating / Q000401:mortality / Q000601:surgery*; D055815:Young Adult
chemical_list: D003404:Creatinine
keywords: Blunt traumatic aortic injury; Endovascular; Risk factor; Trauma
references.citation: Eur J Cardiothorac Surg. 2009 Feb;35(2):282-6
references.pmid: 19081731
references.citation: N Engl J Med. 2008 Oct 16;359(16):1708-16
references.pmid: 18923173
references.citation: J Neurosurg. 2013 Aug;119(2):324-31
references.pmid: 23767893
references.citation: Arch Surg. 2010 Jul;145(7):679-83
references.pmid: 20644131
references.citation: J Vasc Surg. 2013 Aug;58(2):380-5
references.pmid: 23756339
references.citation: Surg Today. 2013 Dec;43(12):1339-46
references.pmid: 23338596
references.citation: J Vasc Surg. 2013 Sep;58(3):832-5
references.pmid: 23643557
references.citation: Ann Vasc Surg. 2013 Nov;27(8):1074-80
references.pmid: 23790766
references.citation: Am Surg. 2013 Jun;79(6):594-600
references.pmid: 23711269
references.citation: Clinics (Sao Paulo). 2011;66(2):267-74
references.pmid: 21484045
references.citation: Resuscitation. 2009 May;80(5):535-9
references.pmid: 19362409
references.citation: Eur Radiol. 2013 Nov;23(11):2988-95
references.pmid: 23722899
references.citation: Ann Thorac Surg. 2013 May;95(5):1591-7
references.pmid: 23541430
references.citation: Eur J Vasc Endovasc Surg. 2011 Jun;41(6):758-69
references.pmid: 21345700
references.citation: Arch Surg. 2006 Feb;141(2):177-80
references.pmid: 16490896
references.citation: Forensic Sci Int. 2010 Feb 25;195(1-3):6-9
references.pmid: 19931340