Traumatic aortic injury score (TRAINS): an easy and simple score for early detection of traumatic aortic injuries in major trauma patients with associated blunt chest trauma

Abstract

Given the relative infrequency of traumatic aortic injury, which often leads to missed or delayed diagnosis, application of our score has the potential to draw necessary clinical attention to the possibility of aortic injury, thus providing the chance of a prompt specific diagnostic and therapeutic management.

Evaluation of patients diagnosed with acute blunt aortic injury and their bedside plain chest radiography in the emergency department: A retrospective study

“…[8,11] Mosquera et al reported mean age to be 41.33 years, and 26.3% of patients were over 55 years of age. [12] Present study results correlated with literature findings. Rupture of the transected aorta in blunt thoracic trauma causes intrathoracic bleeding, which leads to resistant hypotension and a significant risk for mortality if not repaired in time.…”

“…Though not acutely lethal, these injuries may gradually lead to death. [5,12] In the present study, 4 cases had scapula fracture and 2 cases had sternum fracture. Subcutaneous emphysema may arise from direct trauma or esophageal and airway trauma.…”

“…[13] In a multicenter study, Mosquera et al (82 aortic injuries from years 1980-2010) defined a traumatic aortic injury score (TRAINS) that included these criteria: widened mediastinum, hypotension, hemothorax, contusion, left scapular fracture. [12] Mosquera et al found mean RTS to be 5.98 and 34.2% of cases had GCS <9. [12] Present study cases had similar characteristics; however, mean RTS and GCS were higher in this study group.…”

“…[12] Mosquera et al found mean RTS to be 5.98 and 34.2% of cases had GCS <9. [12] Present study cases had similar characteristics; however, mean RTS and GCS were higher in this study group.…”

“…Rupture of the transected aorta in blunt thoracic trauma causes intrathoracic bleeding, which leads to resistant hypotension and a significant risk for mortality if not repaired in time. [5,12] Generally, these patients do not possess significant physical examination findings; however, they are hemodynamically unstable, and in case of high suspicion, CXR provides clues for diagnosis. [5,6] Blackmore et al described 7 risk factors related to aortic injury including age >50 years, BP <90 mmHg and thoracic trauma.…”