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. 2017 Mar 27;12(3):e0171837.
doi: 10.1371/journal.pone.0171837. eCollection 2017.

Treatment of blunt thoracic aortic injury in Germany-Assessment of the TraumaRegister DGU®

Alexander Gombert  1 , Mohammad E Barbati  1 , Martin Storck  2 , Drosos Kotelis  1 , Paula Keschenau  1 , Hans-Christoph Pape  3 , Hagen Andruszkow  3 , Rolf Lefering  4 , Frank Hildebrand  3 , Andreas Greiner  5 , Michael J Jacobs  1 , Jochen Grommes  1
Affiliations

Treatment of blunt thoracic aortic injury in Germany-Assessment of the TraumaRegister DGU®

Alexander Gombert et al. PLoS One. .

Abstract

Purpose: Using the data delivered by the German Trauma Register DGU® from 2002 till 2013, the value of different therapies of blunt thoracic aortic injury (BTAI) in Germany was analyzed.

Methods: Prospectively collected data of patients suffering from BTAI were retrospectively analyzed with focus on the different treatment modalities for grade I-IV injuries.

Results: 821 patients suffering from BTAI were identified: 51.6% (424) grade I injury, 35.4% (291) grade II or III injury and 12.9% (106) grade IV injury (77.5% men [44.94 ± 20.6 years]). The main patterns of injury were high- speed accidents and falls (78.0% [n = 640], 21.8% [n = 171] respectively). Significant differences between grade I and grade II/III as well as IV injuries could be assessed for the incidence of cardiopulmonary resuscitation, a Glasgow Coma Scale score below 8 and a systolic blood pressure below 90 mmHg (p-value: <0.001). In the primary admission subgroup, 44.1% (197/447) of the patients received best medical treatment, 55.9% received surgical intervention (250/447): Thereof 37.2% (93/250) received open surgery and 62.8% (147/250) had been treated by endovascular means. Significantly lower 24-h- and in-hospital-mortality rates were encountered after endovascular treatment for all gradings of BTAI (p-value: <0.001). Yet this subgroup of patients showed the lowest incidence of further severe injuries and cardiac arrest.

Conclusion: Endovascular therapy became the treatment of choice for BTAI in Germany. Patients who have been treated by surgical means showed the highest survival rate, especially endovascular therapy showed a favorable low mortality rate.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The structure of the patients’ selection based on the data delivered by the TraumaRegister.
DGU® from 2002 to 2013.
Fig 2
Fig 2. Development of endovascular and open surgical treatment of BTAI in Germany from 2002 till 2013.
See this image and copyright information in PMC

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References

    1. Lundervall J. The mechanism of traumatic rupture of the aorta. Acta Pathol Microbiol Scand. 1964;62:34–46. - PubMed
    1. Williams JS, Graff JA, Uku JM, Steinig JP. Aortic injury in vehicular trauma. Ann Thorac Surg. 1994;57(3):726–30. - PubMed
    1. Beel T, Harwood AL. Traumatic rupture of the thoracic aorta. Ann Emerg Med. 1980;9(9):483–6. - PubMed
    1. Teixeira PG, Inaba K, Barmparas G, Georgiou C, Toms C, Noguchi TT, et al. Blunt thoracic aortic injuries: an autopsy study. J Trauma. 2011;70(1):197–202. 10.1097/TA.0b013e3181df68b3 - DOI - PubMed
    1. Tong MZ, Koka P, Forbes TL. Economic evaluation of open vs endovascular repair of blunt traumatic thoracic aortic injuries. J Vasc Surg. 2010;52(1):31–8.e3. 10.1016/j.jvs.2010.01.087 - DOI - PubMed

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