Tags

Type your tag names separated by a space and hit enter

Contemporary analysis of thoracic aortic injury: importance of screening based on crash characteristics.
J Trauma. 2007 Jul; 63(1):18-24; discussion 24-5.JT

Abstract

BACKGROUND

To use motor vehicle crash (MVC) characteristics to determine risk of thoracic aortic injury (TAI) and provide updated mortality data.

METHODS

Vehicle crash variables and patient medical data from 64,245 MVC occupants (1988-2002) were obtained from the National Automotive Sampling System. Descriptive and logistic regression analyses were used to determine the relationship of crash and occupant characteristics to TAI.

RESULTS

Seven hundred ninety occupants (1.2%) had TAI. Overall mortality with TAI was 92%. Prehospital mortality was 63%. Patients taken to a trauma center had significantly lower mortality (75%) than did patients taken to a non-trauma center (90%) (p = 0.006). Risk of TAI was highest with a near-side crash impact. Risk of TAI increased with increasing change in velocity and increasing mass of the striking vehicle. Seat belts were protective not only for all occupants in frontal crashes, but also for drivers and front passengers in a near side lateral impact, whereas airbags were protective only in frontal crashes. No specific injuries reliably predicted TAI with sufficient sensitivity and specificity to be clinically useful.

CONCLUSIONS

TAI remains a highly lethal injury. Prehospital mortality in this series is lower than in most previous reports, and survival is higher at trauma centers versus non-trauma centers. Associated injuries are poor predictors of TAI. Screening for TAI should include increased emphasis on crash and vehicle occupant characteristics, especially high-velocity MVC, near-side impact, and lack of seat belt use.

Authors+Show Affiliations

Inova Regional Trauma Center and the Honda Inova Fairfax Hospital CIREN Center, Inova Fairfax Hospital, Falls Church, Virginia 22042, USA. christopher.michetti@inova.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17622864

Citation

Michetti, Christopher P., et al. "Contemporary Analysis of Thoracic Aortic Injury: Importance of Screening Based On Crash Characteristics." The Journal of Trauma, vol. 63, no. 1, 2007, pp. 18-24; discussion 24-5.
Michetti CP, Hanna R, Crandall JR, et al. Contemporary analysis of thoracic aortic injury: importance of screening based on crash characteristics. J Trauma. 2007;63(1):18-24; discussion 24-5.
Michetti, C. P., Hanna, R., Crandall, J. R., & Fakhry, S. M. (2007). Contemporary analysis of thoracic aortic injury: importance of screening based on crash characteristics. The Journal of Trauma, 63(1), 18-24; discussion 24-5.
Michetti CP, et al. Contemporary Analysis of Thoracic Aortic Injury: Importance of Screening Based On Crash Characteristics. J Trauma. 2007;63(1):18-24; discussion 24-5. PubMed PMID: 17622864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contemporary analysis of thoracic aortic injury: importance of screening based on crash characteristics. AU - Michetti,Christopher P, AU - Hanna,Refaat, AU - Crandall,Jeff R, AU - Fakhry,Samir M, PY - 2007/7/12/pubmed PY - 2007/8/3/medline PY - 2007/7/12/entrez SP - 18-24; discussion 24-5 JF - The Journal of trauma JO - J Trauma VL - 63 IS - 1 N2 - BACKGROUND: To use motor vehicle crash (MVC) characteristics to determine risk of thoracic aortic injury (TAI) and provide updated mortality data. METHODS: Vehicle crash variables and patient medical data from 64,245 MVC occupants (1988-2002) were obtained from the National Automotive Sampling System. Descriptive and logistic regression analyses were used to determine the relationship of crash and occupant characteristics to TAI. RESULTS: Seven hundred ninety occupants (1.2%) had TAI. Overall mortality with TAI was 92%. Prehospital mortality was 63%. Patients taken to a trauma center had significantly lower mortality (75%) than did patients taken to a non-trauma center (90%) (p = 0.006). Risk of TAI was highest with a near-side crash impact. Risk of TAI increased with increasing change in velocity and increasing mass of the striking vehicle. Seat belts were protective not only for all occupants in frontal crashes, but also for drivers and front passengers in a near side lateral impact, whereas airbags were protective only in frontal crashes. No specific injuries reliably predicted TAI with sufficient sensitivity and specificity to be clinically useful. CONCLUSIONS: TAI remains a highly lethal injury. Prehospital mortality in this series is lower than in most previous reports, and survival is higher at trauma centers versus non-trauma centers. Associated injuries are poor predictors of TAI. Screening for TAI should include increased emphasis on crash and vehicle occupant characteristics, especially high-velocity MVC, near-side impact, and lack of seat belt use. SN - 1529-8809 UR - https://www.unboundmedicine.com/medline/citation/17622864/Contemporary_analysis_of_thoracic_aortic_injury:_importance_of_screening_based_on_crash_characteristics_ L2 - https://doi.org/10.1097/ta.0b013e31806842bc DB - PRIME DP - Unbound Medicine ER -