title: Evaluation of patients diagnosed with acute blunt aortic injury and their bedside plain chest radiography in the emergency department: A retrospective study.
abstract: BACKGROUND
  The purpose of our study was to retrospectively evaluate traumatic aortic transection patients and their bedside plain chest radiographs for signs of aortic injury.
  
  
  METHODS
  Emergency department (ED) patients from a 5-year period with traumatic aortic transection who were over 18 years of age were included in the study. Demographic characteristics, mechanism of trauma, Revised Trauma Score, Glasgow Coma Score, vital signs, physical exam findings, laboratory parameters, length of stay in the ED, and patient outcomes were documented. Bedside plain chest radiograph images were interpreted by 2 emergency medicine specialists and 1 radiologist.
  
  
  RESULTS
  Thirty patients, mean age 45.87±16.14 years (70% male), were enrolled. Most common trauma mechanism was motor vehicle accident (53.3%). Agreement rates between emergency medicine specialists and radiologist were found to be "excellent" and "substantial" in identifying mediastinal widening and multiple left sided rib fractures; and "fair" in identifying widened paraspinal line, and transthoracic vertebral fractures.
  
  
  CONCLUSIONS
  Though not completely reliable, bedside plain chest radiographs and physical examination findings may be useful in detecting aortic injury during primary survey when the patient is unstable and cannot be sent for chest computerized tomography. Appropriate further imaging studies should be carried out as appropriate based on patient's hemodynamic status.
authors.affiliation: Department of Emergency Medicine, Ege University Faculty of Medicine, İzmir-Turkey. fundakarbek@gmail.com.
authors.forename: Funda
authors.initials: F
authors.lastname: Karbek Akarca
authors.affiliation: Department of Emergency Medicine, İzmir University Faculty of Medicine, İzmir-Turkey.
authors.forename: Tanzer
authors.initials: T
authors.lastname: Korkmaz
authors.affiliation: Department of Radiology, Ege University Faculty of Medicine, İzmir-Turkey.
authors.forename: Celal
authors.initials: C
authors.lastname: Çınar
authors.affiliation: Department of Emergency Medicine, Ege University Faculty of Medicine, İzmir-Turkey.
authors.forename: Elif Dilek
authors.initials: ED
authors.lastname: Çakal
authors.affiliation: Department of Emergency Medicine, Ege University Faculty of Medicine, İzmir-Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ersel
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000293:injuries*; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D012189:Retrospective Studies; D012253:Rib Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging; D013898:Thoracic Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014421:Turkey; D057772:Vascular System Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000000981:diagnostic imaging*; D055815:Young Adult