Injury to the thoracic aorta following fatal blunt trauma: an autopsy study.

Background: Transection of the thoracic aorta (TTA) remains a leading cause of death after blunt trauma. In this autopsy study, the natural history of this injury is reviewed. Patients and Methods: All blunt trauma deaths that occurred in the Milano urban area over a period of one year were collecte...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 35; no. 3; pp. 305 - 311
Autores principales: Chiara O, Cimbanassi S, Zoia R
Formato: research tables/charts Journal Article
Publicado: Springer Nature Jun2009
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: European Journal of Trauma & Emergency Surgery
      issn: 18639933
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      dt: Jun2009
      vid: 35
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      pub: Springer Nature
      place: New York, New York
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        105365211
        2010323786
        10.1007/s00068-008-8187-5
        105365211
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        atl: Injury to the thoracic aorta following fatal blunt trauma: an autopsy study.
      aug:
        au:
          Chiara O
          Cimbanassi S
          Zoia R
        affil: Trauma Team Department DEA-EAS Hospital Niguarda Ca'Granda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy, e-mail: ochiara@yahoo.com,
      sug:
        subj:
          Aorta Injuries
          Fatal Outcome
          Wounds, Nonpenetrating Complications
          Accidental Falls
          Accidents, Traffic
          Adult
          Aged
          Aorta Anatomy and Histology
          Autopsy
          Cause of Death
          Descriptive Statistics
          Female
          Italy
          Male
          Middle Age
          Prospective Studies
          Scales
          Urban Areas
          Wounds, Nonpenetrating Epidemiology
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Transection of the thoracic aorta (TTA) remains a leading cause of death after blunt trauma. In this autopsy study, the natural history of this injury is reviewed. Patients and Methods: All blunt trauma deaths that occurred in the Milano urban area over a period of one year were collected. Autopsies were available in all cases. Incidence, mechanisms, anatomical locations of TTA, deaths due to TTA or coexisting injuries, and times of death were reviewed. Cause of death was established. Death was attributed to TTA if its abbreviated injury score was six (hemorrhage not confined to the mediastinum). Results: 199 cases of fatal blunt trauma were included, 72% of which were males; mean age 53 ± 21. A TTA was observed in 53 subjects (27%), with a significantly higher incidence between the ages of 45 and 64 years and after falls from height. The aorta was transected at the isthmus in 36% of cases. Victims with TTA had a higher pre-hospital mortality and more injuries to chest organs, the chest wall and pelvis. In victims with TTA, injury to the aorta was the cause of death in 58%. Only five patients with TTA survived more than 1 h, reaching the hospital alive; four of these died due to the rupture of a mediastinal hematoma during the first hours of in-hospital care. Conclusions: This study demonstrates that TTA is a frequent cause of immediate deaths among blunt trauma victims. Patients with risk factors for TTA who reach the hospital alive need to be promptly investigated with a contrast CT scan. Evidence of mediastinal hematoma is suggestive for possible rapid evolution.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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