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  1. Prospective study of blunt aortic injury : Multicenter Trial of the American Association for the Surgery of Trauma. Commentary.

    Article, Communication - En anglais

    Annual Meeting of the American Association for the Surgery of Trauma. Houston, Texas (USA), 1996/09/19.

    Background 

    Blunt aortic injury is a major cause of death from blunt trauma.

    Evolution of diagnostic techniques and methods of operative repair have altered the management and posed new questions in recent years.

    Methods 

    This study was a prospectively conducted multicenter trial involving 50 trauma centers in North America under the direction of the Multi-institutional Trial Committee of the American Association for the Surgery of Trauma.

    Results 

    There were 274 blunt aortic injury cases studied over 2.5 years, of which 81% were caused by automobile crashes.

    Chest computed tomography and transesophageal echocardiography were applied in 88 and 30 cases, respectively, and were 75 and 80% diagnostic, respectively.

    Two hundred seven stable patients underwent planned thoracotomy and repair.

    Clamp and sew technique was used in 73 (35%) and bypass techniques in 134 (65%). Overall mortality was 31%, with 63% of deaths being attributable to aortic rupture ; mortality was not affected by method of repair.

    Paraplegia occurred postoperatively in 8.7%. Logistic regression analysis demonstrated clamp and sew (p=0.002) and aortic cross clamp time of 30 minutes (p=0.01) to be associated with development of postoperative paraplegia.

    Conclusions 

    Rupture after hospital admission remains a major problem.

    Although newer diagnostic techniques are being applied, at this time aortography remains the diagnostic standard. (...)

    Mots-clés Pascal : Traumatisme, Aorte, Homme, Epidémiologie, Traumatologie, Amérique du Nord, Amérique, Etude longitudinale, Diagnostic, Traitement, Etude multicentrique, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Aorte pathologie

    Mots-clés Pascal anglais : Trauma, Aorta, Human, Epidemiology, Traumatology, North America, America, Follow up study, Diagnosis, Treatment, Multicenter study, Cardiovascular disease, Vascular disease, Aortic disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0290533

    Code Inist : 002B16I. Création : 15/07/1997.