| A contemporary rural trauma center experience in blunt traumatic aortic injury. | |
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MedLine Citation:
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PMID: 20655683 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Traumatic aortic injury (TAI) is a rare yet highly lethal injury associated with blunt force deceleration injury. The adoption of thoracic endovascular aortic repair (TEVAR) has become a safer option than traditional open repair. The purpose of this study is to review a rural trauma center experience with TAI. METHODS: A retrospective analysis was performed, reviewing all patients who presented with TAI between 2000 and 2009. Clinical, anatomical, and procedural variables of all cases were systematically reviewed. Clinical endpoints included mortality, and aortic-related mortality, and hospital length of stay. The study population was stratified by those that underwent surgical repair (SR) and those managed medically (MM). RESULTS: Fifty-six patients presented with blunt TAI; 35 patients (62.5%) were surgically repaired (22 open, 13 TEVAR), while 21 (37.5%) were MM. The only difference in comorbidities was a higher rate of coronary artery disease in MM. Mean hospital arrival time (SR, 188.6 ± 30.3 minutes, MM, 253 ± 65.3 minutes), aortic injury grade (SR, 2.7 ± 0.1; MM, 2.3 ± 0.2), and injury severity score were not significantly different between the groups. Head Abbreviated Injury Score (AIS) was worse in the MM group, while chest AIS was worse in the SR group (P < .05). There were nine (42.9%) deaths in the MM group, while there were only two (5.7%) in the SR group (P < .001). There was no significant difference in aortic-related mortality. Mean follow-up time was not statistically different. CONCLUSION: These data provide a group of stable patients to examine the management of TAI in the endovascular era. The low aortic-related mortality in the MM group demonstrates that there is time for a thorough evaluation in patients sustaining TAI who arrive without hemodynamic instability. |
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Authors:
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Christopher A Durham; Michael M McNally; Frank M Parker; William M Bogey; Charles S Powell; Claudia E Goettler; Michael F Rotondo; Michael C Stoner |
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Publication Detail:
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Type: Journal Article Date: 2010-07-23 |
Journal Detail:
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Title: Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter Volume: 52 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-04 Completed Date: 2010-10-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 884-9; discussion 889-90 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Surgery, East Carolina University, Greenville, NC, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aorta / injuries, physiopathology, surgery* Chi-Square Distribution Female Hemodynamics Hospitals, Rural* / statistics & numerical data Humans Kaplan-Meiers Estimate Length of Stay Male Middle Aged North Carolina Registries Retrospective Studies Risk Assessment Risk Factors Severity of Illness Index Time Factors Trauma Centers* / statistics & numerical data Treatment Outcome Vascular Surgical Procedures* / adverse effects, mortality Wounds, Nonpenetrating / diagnosis, mortality, physiopathology, surgery, therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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