Prospective study of blunt aortic injury : Multicenter Trial of the American Association for the Surgery of Trauma. Commentary.
Annual Meeting of the American Association for the Surgery of Trauma. Houston, Texas (USA), 1996/09/19.
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.
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.
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.
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
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0290533
Code Inist : 002B16I. Création : 15/07/1997.