Nationwide Analysis of Penetrating Thoracic Aortic Injury: Injury Patterns, Management, and Outcomes
Penetrating thoracic aortic injuries (PTAI) represent a rare form of thoracic trauma. Unlike blunt thoracic aortic injuries (BTAI), only scarce data, included in small case series, are currently available for PTAI. The purpose of this study was to describe injury patterns, surgical management, and o...
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| Veröffentlicht in: | The Journal of surgical research 2023-04, Vol.284, p.290-295 |
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| creator | Slocum, Charles Chiba, Hiroto Emigh, Brent Tam, Benjamin Schellenberg, Morgan Inaba, Kenji Matsushima, Kazuhide |
| description | Penetrating thoracic aortic injuries (PTAI) represent a rare form of thoracic trauma. Unlike blunt thoracic aortic injuries (BTAI), only scarce data, included in small case series, are currently available for PTAI. The purpose of this study was to describe injury patterns, surgical management, and outcomes of patients with PTAI and compare to those with BTAI.
A 9-y retrospective cohort study (2007-2015) was conducted using the National Trauma Data Bank. Patient demographics, injury profile, procedures performed, and patient outcomes were compared between the PTAI and BTAI group.
A total of 2714 patients with PTAI and 14,037 patients with BTAI were identified. Compared to BTAI, PTAI patients were younger (28 versus 42 y, P |
| doi_str_mv | 10.1016/j.jss.2022.11.077 |
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A 9-y retrospective cohort study (2007-2015) was conducted using the National Trauma Data Bank. Patient demographics, injury profile, procedures performed, and patient outcomes were compared between the PTAI and BTAI group.
A total of 2714 patients with PTAI and 14,037 patients with BTAI were identified. Compared to BTAI, PTAI patients were younger (28 versus 42 y, P < 0.001), more often male (89.1% versus 71.7%, P < 0.001), and more likely to arrive without signs of life (27.6% versus 7.5%, P < 0.001). PTAI patients had less associated injuries, overall, compared to those with BTAI; however, were more likely to have injuries to the esophagus, diaphragm, and heart. Patients with PTAI were less likely to undergo endovascular (5.8% versus 30.5%, P < 0.001) or open surgical repair (3.0% versus 4.2%, P < 0.001) compared to BTAI. While the large majority of PTAI patients expired before their hospital arrival or in the emergency department, the in-hospital mortality rate among those who survivedemergency department stay was 43.1%.
Most patients with PTAI present to the hospital without any signs of life, and their overall mortality rate is extremely high. Only a small portion of PTAI patients who survived the initial resuscitation period underwent surgical interventions for thoracic aortic injuries. Further studies are still warranted to clarify the indications and types of surgical interventions for PTAI.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2022.11.077</identifier><identifier>PMID: 36621259</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aorta, Thoracic - injuries ; Aorta, Thoracic - surgery ; Endovascular Procedures - methods ; Humans ; Male ; Management ; Patient outcomes ; Penetrating thoracic aortic injury ; Retrospective Studies ; Surgical interventions ; Thoracic Injuries - epidemiology ; Thoracic Injuries - surgery ; Treatment Outcome ; Vascular System Injuries - epidemiology ; Vascular System Injuries - surgery ; Wounds, Nonpenetrating - diagnosis ; Wounds, Nonpenetrating - epidemiology ; Wounds, Nonpenetrating - surgery</subject><ispartof>The Journal of surgical research, 2023-04, Vol.284, p.290-295</ispartof><rights>2022 Elsevier Inc.</rights><rights>Copyright © 2022 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-61d6a84992af40ff6727997c5c2e470ee3485561a581a6bb4c87d78d459eb72c3</citedby><cites>FETCH-LOGICAL-c353t-61d6a84992af40ff6727997c5c2e470ee3485561a581a6bb4c87d78d459eb72c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jss.2022.11.077$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36621259$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Slocum, Charles</creatorcontrib><creatorcontrib>Chiba, Hiroto</creatorcontrib><creatorcontrib>Emigh, Brent</creatorcontrib><creatorcontrib>Tam, Benjamin</creatorcontrib><creatorcontrib>Schellenberg, Morgan</creatorcontrib><creatorcontrib>Inaba, Kenji</creatorcontrib><creatorcontrib>Matsushima, Kazuhide</creatorcontrib><title>Nationwide Analysis of Penetrating Thoracic Aortic Injury: Injury Patterns, Management, and Outcomes</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>Penetrating thoracic aortic injuries (PTAI) represent a rare form of thoracic trauma. Unlike blunt thoracic aortic injuries (BTAI), only scarce data, included in small case series, are currently available for PTAI. The purpose of this study was to describe injury patterns, surgical management, and outcomes of patients with PTAI and compare to those with BTAI.
A 9-y retrospective cohort study (2007-2015) was conducted using the National Trauma Data Bank. Patient demographics, injury profile, procedures performed, and patient outcomes were compared between the PTAI and BTAI group.
A total of 2714 patients with PTAI and 14,037 patients with BTAI were identified. Compared to BTAI, PTAI patients were younger (28 versus 42 y, P < 0.001), more often male (89.1% versus 71.7%, P < 0.001), and more likely to arrive without signs of life (27.6% versus 7.5%, P < 0.001). PTAI patients had less associated injuries, overall, compared to those with BTAI; however, were more likely to have injuries to the esophagus, diaphragm, and heart. Patients with PTAI were less likely to undergo endovascular (5.8% versus 30.5%, P < 0.001) or open surgical repair (3.0% versus 4.2%, P < 0.001) compared to BTAI. While the large majority of PTAI patients expired before their hospital arrival or in the emergency department, the in-hospital mortality rate among those who survivedemergency department stay was 43.1%.
Most patients with PTAI present to the hospital without any signs of life, and their overall mortality rate is extremely high. Only a small portion of PTAI patients who survived the initial resuscitation period underwent surgical interventions for thoracic aortic injuries. Further studies are still warranted to clarify the indications and types of surgical interventions for PTAI.</description><subject>Aorta, Thoracic - injuries</subject><subject>Aorta, Thoracic - surgery</subject><subject>Endovascular Procedures - methods</subject><subject>Humans</subject><subject>Male</subject><subject>Management</subject><subject>Patient outcomes</subject><subject>Penetrating thoracic aortic injury</subject><subject>Retrospective Studies</subject><subject>Surgical interventions</subject><subject>Thoracic Injuries - epidemiology</subject><subject>Thoracic Injuries - surgery</subject><subject>Treatment Outcome</subject><subject>Vascular System Injuries - epidemiology</subject><subject>Vascular System Injuries - surgery</subject><subject>Wounds, Nonpenetrating - diagnosis</subject><subject>Wounds, Nonpenetrating - epidemiology</subject><subject>Wounds, Nonpenetrating - surgery</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9PHCEYxkljU7e2H6AXw9GDMwWGgUFPG2NbE1s92DNh4R3LZAcUGJv99sXstseenrx5_iTvD6FPlLSUUPF5aqecW0YYayltiZRv0IoS1TeDkN0RWpHqNHwg_Bi9z3ki9Vaye4eOOyEYZb1aIffDFB_Db-8Ar4PZ7rLPOI74HgKUVL3wiB9-xWSst3gdU6lyE6Yl7S4Oiu9NKZBCPsffTTCPMEMo59gEh--WYuMM-QN6O5ptho8HPUE_v1w_XH1rbu--3lytbxvb9V1pBHXCDFwpZkZOxlFIJpWStrcMuCQAHR_6XlDTD9SIzYbbQTo5ON4r2EhmuxN0tt99SvF5gVz07LOF7dYEiEvWTAo2UMmFqlG6j9oUc04w6qfkZ5N2mhL9CldPusLVr3A1pbrCrZ3Tw_yymcH9a_ylWQOX-wDUJ188JJ2th2DB-QS2aBf9f-b_AGNbilo</recordid><startdate>202304</startdate><enddate>202304</enddate><creator>Slocum, Charles</creator><creator>Chiba, Hiroto</creator><creator>Emigh, Brent</creator><creator>Tam, Benjamin</creator><creator>Schellenberg, Morgan</creator><creator>Inaba, Kenji</creator><creator>Matsushima, Kazuhide</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202304</creationdate><title>Nationwide Analysis of Penetrating Thoracic Aortic Injury: Injury Patterns, Management, and Outcomes</title><author>Slocum, Charles ; Chiba, Hiroto ; Emigh, Brent ; Tam, Benjamin ; Schellenberg, Morgan ; Inaba, Kenji ; Matsushima, Kazuhide</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-61d6a84992af40ff6727997c5c2e470ee3485561a581a6bb4c87d78d459eb72c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aorta, Thoracic - injuries</topic><topic>Aorta, Thoracic - surgery</topic><topic>Endovascular Procedures - methods</topic><topic>Humans</topic><topic>Male</topic><topic>Management</topic><topic>Patient outcomes</topic><topic>Penetrating thoracic aortic injury</topic><topic>Retrospective Studies</topic><topic>Surgical interventions</topic><topic>Thoracic Injuries - epidemiology</topic><topic>Thoracic Injuries - surgery</topic><topic>Treatment Outcome</topic><topic>Vascular System Injuries - epidemiology</topic><topic>Vascular System Injuries - surgery</topic><topic>Wounds, Nonpenetrating - diagnosis</topic><topic>Wounds, Nonpenetrating - epidemiology</topic><topic>Wounds, Nonpenetrating - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Slocum, Charles</creatorcontrib><creatorcontrib>Chiba, Hiroto</creatorcontrib><creatorcontrib>Emigh, Brent</creatorcontrib><creatorcontrib>Tam, Benjamin</creatorcontrib><creatorcontrib>Schellenberg, Morgan</creatorcontrib><creatorcontrib>Inaba, Kenji</creatorcontrib><creatorcontrib>Matsushima, Kazuhide</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Slocum, Charles</au><au>Chiba, Hiroto</au><au>Emigh, Brent</au><au>Tam, Benjamin</au><au>Schellenberg, Morgan</au><au>Inaba, Kenji</au><au>Matsushima, Kazuhide</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nationwide Analysis of Penetrating Thoracic Aortic Injury: Injury Patterns, Management, and Outcomes</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2023-04</date><risdate>2023</risdate><volume>284</volume><spage>290</spage><epage>295</epage><pages>290-295</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>Penetrating thoracic aortic injuries (PTAI) represent a rare form of thoracic trauma. Unlike blunt thoracic aortic injuries (BTAI), only scarce data, included in small case series, are currently available for PTAI. The purpose of this study was to describe injury patterns, surgical management, and outcomes of patients with PTAI and compare to those with BTAI.
A 9-y retrospective cohort study (2007-2015) was conducted using the National Trauma Data Bank. Patient demographics, injury profile, procedures performed, and patient outcomes were compared between the PTAI and BTAI group.
A total of 2714 patients with PTAI and 14,037 patients with BTAI were identified. Compared to BTAI, PTAI patients were younger (28 versus 42 y, P < 0.001), more often male (89.1% versus 71.7%, P < 0.001), and more likely to arrive without signs of life (27.6% versus 7.5%, P < 0.001). PTAI patients had less associated injuries, overall, compared to those with BTAI; however, were more likely to have injuries to the esophagus, diaphragm, and heart. Patients with PTAI were less likely to undergo endovascular (5.8% versus 30.5%, P < 0.001) or open surgical repair (3.0% versus 4.2%, P < 0.001) compared to BTAI. While the large majority of PTAI patients expired before their hospital arrival or in the emergency department, the in-hospital mortality rate among those who survivedemergency department stay was 43.1%.
Most patients with PTAI present to the hospital without any signs of life, and their overall mortality rate is extremely high. Only a small portion of PTAI patients who survived the initial resuscitation period underwent surgical interventions for thoracic aortic injuries. Further studies are still warranted to clarify the indications and types of surgical interventions for PTAI.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36621259</pmid><doi>10.1016/j.jss.2022.11.077</doi><tpages>6</tpages></addata></record> |
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| subjects | Aorta, Thoracic - injuries Aorta, Thoracic - surgery Endovascular Procedures - methods Humans Male Management Patient outcomes Penetrating thoracic aortic injury Retrospective Studies Surgical interventions Thoracic Injuries - epidemiology Thoracic Injuries - surgery Treatment Outcome Vascular System Injuries - epidemiology Vascular System Injuries - surgery Wounds, Nonpenetrating - diagnosis Wounds, Nonpenetrating - epidemiology Wounds, Nonpenetrating - surgery |
| title | Nationwide Analysis of Penetrating Thoracic Aortic Injury: Injury Patterns, Management, and Outcomes |
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