Contemporary Analysis of Thoracic Aortic Injury: Importance of Screening Based on Crash Characteristics (With Discussion)

The authors discuss the use of motor vehicle crash (MVC) characteristics for updated mortality data provision and thoracic aortic injury (TAI) risk. The National Automotive Sampling System provided patient medical data and vehicle crash variables from 64,245 MVC occupants (1988-2002). The relationship of occupant and crash characteristics to TAI were determined through logistic and descriptive regression analyses. TAI was found in 790 occupants, with a 92% overall mortality rate, 63% prehospital, in the group. Patients taken to a nontrauma center (90%) had a significantly higher mortality rate than those taken to a trauma center (75%) (p=0.006). Near-side crash impact had the highest TAI risk. TAI risk increased when, in the striking vehicle, there was increasing velocity change and increasing mass. Seat belts protected, in near side lateral impact MVCs, drivers and front passengers, in addition to, in frontal crashes, all occupants. TAI was not reliably predicted by any specific injuries with enough specificity and sensitivity for clinical usefulness. The authors conclude that TAI is still highly lethal. In this series, trauma center survival is higher than nontrauma center survival, and prehospital mortality is lower than in most previous reports. TAI prediction is poor using associated injuries. TAI screening should include increased vehicle occupant and crash characteristics emphasis, especially seat belt non-use, near-side impact, and high velocity MVCs. Discussion follows the article.

  • Availability:
  • Authors:
    • Michetti, Christopher P
    • Hanna, Refaat
    • Crandall, Jeff R
    • Fakhry, Samir M
  • Publication Date: 2007-7

Language

  • English

Media Info

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Filing Info

  • Accession Number: 01054323
  • Record Type: Publication
  • Files: TRIS
  • Created Date: Jul 24 2007 5:48PM