title: Treatment of blunt thoracic aortic injury in Germany-Assessment of the TraumaRegister DGU®.
abstract: OBJECTIVE
  Using the data delivered by the German Trauma Register DGU® from 2002 till 2013, the value of different therapies of blunt thoracic aortic injury (BTAI) in Germany was analyzed.
  
  
  METHODS
  Prospectively collected data of patients suffering from BTAI were retrospectively analyzed with focus on the different treatment modalities for grade I-IV injuries.
  
  
  RESULTS
  821 patients suffering from BTAI were identified: 51.6% (424) grade I injury, 35.4% (291) grade II or III injury and 12.9% (106) grade IV injury (77.5% men [44.94 ± 20.6 years]). The main patterns of injury were high- speed accidents and falls (78.0% [n = 640], 21.8% [n = 171] respectively). Significant differences between grade I and grade II/III as well as IV injuries could be assessed for the incidence of cardiopulmonary resuscitation, a Glasgow Coma Scale score below 8 and a systolic blood pressure below 90 mmHg (p-value: <0.001). In the primary admission subgroup, 44.1% (197/447) of the patients received best medical treatment, 55.9% received surgical intervention (250/447): Thereof 37.2% (93/250) received open surgery and 62.8% (147/250) had been treated by endovascular means. Significantly lower 24-h- and in-hospital-mortality rates were encountered after endovascular treatment for all gradings of BTAI (p-value: <0.001). Yet this subgroup of patients showed the lowest incidence of further severe injuries and cardiac arrest.
  
  
  CONCLUSIONS
  Endovascular therapy became the treatment of choice for BTAI in Germany. Patients who have been treated by surgical means showed the highest survival rate, especially endovascular therapy showed a favorable low mortality rate.
authors.affiliation: European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Gombert
authors.affiliation: European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Mohammad E
authors.initials: ME
authors.lastname: Barbati
authors.affiliation: Klinikum Karlsruhe, Academic Teaching Hospital Univ. Freiburg, Karlsruhe, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Storck
authors.affiliation: European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Drosos
authors.initials: D
authors.lastname: Kotelis
authors.affiliation: European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Paula
authors.initials: P
authors.lastname: Keschenau
authors.affiliation: Department of Orthopedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Pape
authors.affiliation: Department of Orthopedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Hagen
authors.initials: H
authors.lastname: Andruszkow
authors.affiliation: Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
authors.affiliation: Department of Orthopedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Hildebrand
authors.affiliation: Department of Vascular Surgery, University Hospital Charité Berlin, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Greiner
authors.affiliation: European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Jacobs
authors.affiliation: European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Grommes
mesh_terms: D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000293:injuries* / Q000601:surgery*; D057510:Endovascular Procedures; D005260:Female; D005858:Germany / Q000453:epidemiology; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013898:Thoracic Injuries / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000601:surgery*; D055815:Young Adult