Identification of Trauma Patients at Risk of Thoracic Aortic Tear by Mechanism of Injury

Abstract

Thoracic aortic injury after vehicular collision can be reliably excluded if near-impact, Delta V > or = 20 mph, or intrusion > or = 15 inches are not present. Mechanism of injury in the form of crash scene information may aid clinicians in identifying individuals at risk for thoracic aortic tear after vehicular trauma.

Mechanism of Injury Predicts Patient Mortality and Impairment After Blunt Trauma

“…For example, MOI can augment field triage decisions and can assist on-scene emergency personnel to consider potential injuries such as a thoracic aortic tear or cervical spine injury in their initial assessments [1,18]. In a retrospective analysis of all admissions to a level I trauma center, MOI was a significant predictor for immediate operating room or intensive care needs [19].…”

Comparison of Distributions of Key Predictor Variables in CIREN and NASS-CDS Cases Meeting CIREN Inclusion Criteria

“…A number of papers have analyzed CIREN data inappropriately by comparing cases with an injury of interest in CIREN to "uninjured" CIREN cases, defined as occupants without the injury of interest (e.g., Horton et al 2000;Nirula and Pintar 2008;Siegel et al 2001;Smith et al 2005;Stein et al 2006). Because all cases in CIREN are seriously injured in some way, they cannot provide an appropriate comparison group to study the effect of predictors on injury risk.…”

“…Typically, these estimates are based on logistic regressions and categorical analyses in which CIREN occupants with an injury of interest are used as cases and CIREN occupants without the injury of interest are used as a source of control or exposure information (e.g., Horton et al 2000;Nirula and Pintar, 2008;Siegel et al 2001;Smith et al 2005;Stein et al 2006). Such analyses can appear to show an effect of exposure to a particular variable that has little relationship to the true effect.…”

Kinematics of Belted Fatalities in Frontal Collisions: A New Approach in Deep Studies of Injury Mechanisms

“…This finding is in agreement with other studies of aortic injuries in motor vehicle collisions. Horton et al 23 found that the majority of these injuries were produced by near side crashes. Different opinions regarding whether frontal or lateral crashes produce the majority of aortic injuries can be found in the literature.…”