Abstract
Background: Trauma-induced aortic injuries continue to be an important factor in morbimortality in patients with blunt trauma. Objectives: To determine the characteristics of aortic lesions in patients with closed thoracic trauma and associated thoracic injuries. Methods: Multicenter cohort study conducted during the years 1994 to 2014 in the radiology service in the University Hospital Complex of A Coruña. Patients >15 years with closed thoracic trauma were included. Sociodemographic and clinical variables were studied in order to determine the lesion cause, location, and degree. Results: We analyzed 232 patients with a mean age of 46.9 ± 18.7 years, consisting of 81.4% males. The most frequent location was at the level of the isthmus (55.2%). The most frequent causes of injury were traffic accidents followed by falls. Patients with aortic injury had more esophageal, airway, and cardiopericardial lesions. More than 85% of the patients had lung parenchyma and/or chest wall injury, which was more prevalent among those who did not have an aortic lesion. Conclusions: Patients with trauma due to traffic accidents or being run over presented three times more risk of aortic injury than from other causes. Those with an aortic lesion also had a higher frequency of cardiopericardial, airway, and esophageal lesions.
Highlights
Trauma is the leading cause of death in those under 45 years of age in the United States and the European Union [1,2,3]
There is a great controversy regarding what the true mechanism of injury is in blunt trauma of the aorta; currently it is considered that the union of shearing forces with a rapid deceleration, hydrostatic forces, and the mechanism of the bone clamp help to promote this traumatism [6,7,8]
We included patients older than 15 years, with closed thoracic trauma with an assessment of the severity of the injury greater than 15 according to the Injury Severity Score (ISS) [10] and who received presented emergency computed tomography (CT) in which the presence of an aortic lesion associated with trauma it could be objectified or ruled out
Summary
Trauma is the leading cause of death in those under 45 years of age in the United States and the European Union [1,2,3]. In Spain, traumatisms due to traffic accidents are the first cause of death in those under 34 years of age [4]. Objectives: To determine the characteristics of aortic lesions in patients with closed thoracic trauma and associated thoracic injuries. The most frequent causes of injury were traffic accidents followed by falls. Patients with aortic injury had more esophageal, airway, and cardiopericardial lesions. Conclusions: Patients with trauma due to traffic accidents or being run over presented three times more risk of aortic injury than from other causes. Those with an aortic lesion had a higher frequency of cardiopericardial, airway, and esophageal lesions
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