title: Predictors of Discharge Home after Blunt Traumatic Thoracic Aortic Injury.
abstract: BACKGROUND
  Blunt traumatic thoracic aortic injury (BTAI) can be a highly lethal injury but in the last decade major advances have been made in diagnostic accuracy, injury grading, and therapy. Traditionally, emphasis has been on studying survival postinjury with a paucity of studies examining the discharge characteristics of patients that survive a BTAI. The purpose of this study is to define the epidemiology and predictors of disposition in patients with BTAI in a provincial database.
  
  
  METHODS
  Using the Ontario Trauma Registry, all patients were identified who were hospitalized with a BTAI between 1999 and 2009. Trends in therapy and discharge disposition were determined.
  
  
  RESULTS
  We identified 264 cases of BTAI. Of these, 157 were discharged from hospital with 36% (n = 56) going directly home and 64% (n = 101) going to continuing care facilities. There was no difference in disposition in those with BTAI treated operatively or nonoperatively (P = 0.48). In those that had repair of BTAI, there was no difference in discharge home between open and endovascular repair (P = 1.00). Univariate analyses identified younger age, male sex, lower injury severity score (ISS), and lower Charlson comorbidity indices as being predictors of discharge home. On adjusted multivariate regression analysis, lower ISS (odds ratio, 0.91; 95% confidence interval, 0.87-0.95; P < 0.001) was the only independent predictors of discharge home.
  
  
  CONCLUSIONS
  Our findings suggest that the only independent predictor for discharge home for patients who survive is the overall severity of all their injuries irrespective of their condition on admission or management of their BTAI.
authors.affiliation: Division of General Surgery, London Health Sciences Centre, Victoria Hospital, Western University, London, Ontario, Canada.
authors.forename: Mostafa H
authors.initials: MH
authors.lastname: El-Beheiry
authors.affiliation: Division of General Surgery, London Health Sciences Centre, Victoria Hospital, Western University, London, Ontario, Canada.
authors.forename: Biniam
authors.initials: B
authors.lastname: Kidane
authors.affiliation: Division of Trauma, London Health Sciences Centre, Victoria Hospital, Western University, London, Ontario, Canada.
authors.forename: Meaghan
authors.initials: M
authors.lastname: Zehr
authors.affiliation: Division of General Surgery, London Health Sciences Centre, Victoria Hospital, Western University, London, Ontario, Canada; Division of Vascular Surgery, Toronto General Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada.
authors.forename: Kelly
authors.initials: K
authors.lastname: Vogt
authors.affiliation: Division of General Surgery, London Health Sciences Centre, Victoria Hospital, Western University, London, Ontario, Canada; Division of Trauma, London Health Sciences Centre, Victoria Hospital, Western University, London, Ontario, Canada.
authors.forename: Neil G
authors.initials: NG
authors.lastname: Parry
authors.affiliation: Division of Thoracic Surgery, London Health Sciences Centre, Victoria Hospital, Western University, London, Ontario, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Malthaner
authors.affiliation: Division of Vascular Surgery, Toronto General Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada. Electronic address: thomas.forbes@uhn.ca.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Forbes
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000293:injuries*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010351:Patient Discharge; D012189:Retrospective Studies; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D055815:Young Adult