Prospective study of blunt aortic injury: Multicenter trial of the American Association for the Surgery of Trauma

摘要: Background: Blunt aortic injury is a major cause of death from blunt trauma. Evolution diagnostic techniques and methods operative repair have altered the management posed new questions in recent years. Methods: This study was prospectively conducted multicenter trial involving 50 trauma centers North America under direction Multi-institutional Trial Committee American Association for Surgery Trauma. Results: There were 274 cases studied over 2.5 years, which 81% caused by automobile crashes. Chest computed tomography transesophageal echocardiography applied 88 30 cases, respectively, 75 80% diagnostic, respectively. Two hundred seven stable patients underwent planned thoracotomy repair. Clamp sew technique used 73 (35%) bypass 134 (65%). Overall mortality 31%, with 63% deaths being attributable to rupture; not affected method Paraplegia occurred postoperatively 8.7%. Logistic regression analysis demonstrated clamp (p = 0.002) cross time minutes 0.01) be associated development postoperative paraplegia. Conclusions: Rupture after hospital admission remains problem. Although newer are applied, at this aortography standard. Aortic beyond paraplegia; techniques, provide distal perfusion, produced significantly lower paraplegia rates than approach.