Aortic transection: demographics, treatment and outcomes in Victoria, Australia

Hiller, Ryan J., Mikocka-Walus, Antonina A. and Cameron, Peter A. 2010, Aortic transection: demographics, treatment and outcomes in Victoria, Australia, Emergency medicine journal, vol. 27, no. 5, pp. 368-371, doi: 10.1136/emj.2009.075978.

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Title Aortic transection: demographics, treatment and outcomes in Victoria, Australia
Author(s) Hiller, Ryan J.
Mikocka-Walus, Antonina A.ORCID iD for Mikocka-Walus, Antonina A.
Cameron, Peter A.
Journal name Emergency medicine journal
Volume number 27
Issue number 5
Start page 368
End page 371
Total pages 4
Publisher BMJ Group
Place of publication London, Eng.
Publication date 2010-05
ISSN 1472-0205
Keyword(s) Accidents, Traffic
Aorta, Thoracic
Aortic Rupture
Hospital Mortality
Middle Aged
Treatment Outcome
Vascular System Injuries
Wounds, Nonpenetrating
Summary OBJECTIVE: The epidemiology of aortic transection is changing with improvements in road safety and the use of endovascular stents. This research investigates the profile of cases and outcomes of traumatic thoracic aortic transection in Victoria, Australia.

METHODS: Data were extracted from the Victorian State Trauma Registry for the period July 2001 to December 2007. Data pertaining to patient demographics, mechanism of injury, method of treatment and mortality were collected. Prehospital mortality for the first year was assessed using National Coroners Information System data. Figures from the Australian Bureau of Statistics were used to establish population incidence rates.

RESULTS: 69 patients reaching hospital were identified with transection over the study period. A total of 85 cases of transection were identified through coroners' records. Overall mortality (including prehospital and hospital) was approximately 94.4%. Prehospital mortality was approximately 88.0%. Overall hospital mortality was 33.3%. Patients were predominately men (73.9%) and had a median age of 38 years. Motor vehicle collisions were the most common mechanism (56.5%), with 85.5% of injuries being traffic related. Repair was performed in 46 patients, with 22 receiving initial endovascular repair and 24 receiving initial open repair. Mortality rates following surgery were 9.1% and 16.7%, respectively.

CONCLUSIONS: Aortic transection was generally secondary to traffic-related injury affecting young men, with a mortality rate of over 90%. There has been a trend towards endovascular treatment over open repair in Victorian trauma centres.
Language eng
DOI 10.1136/emj.2009.075978
Field of Research 111716 Preventive Medicine
111706 Epidemiology
110305 Emergency Medicine
1103 Clinical Sciences
1110 Nursing
1117 Public Health And Health Services
Socio Economic Objective 920412 Preventive Medicine
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2010, Royal College of Emergency Medicine & BMJ Group
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