Treatment of blunt thoracic aortic injury in Germany-Assessment of the TraumaRegister DGU®.
PURPOSE:Using the data delivered by the German Trauma Register DGU® from 2002 till 2013, the value of different therapies of blunt thoracic aortic injury (BTAI) in Germany was analyzed. METHODS:Prospectively collected data of patients suffering from BTAI were retrospectively analyzed with focus on t...
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doaj-0d5fa48939144184b6295352f9fd49442020-11-25T01:36:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01123e017183710.1371/journal.pone.0171837Treatment of blunt thoracic aortic injury in Germany-Assessment of the TraumaRegister DGU®.Alexander GombertMohammad E BarbatiMartin StorckDrosos KotelisPaula KeschenauHans-Christoph PapeHagen AndruszkowRolf LeferingFrank HildebrandAndreas GreinerMichael J JacobsJochen GrommesPURPOSE:Using the data delivered by the German Trauma Register DGU® from 2002 till 2013, the value of different therapies of blunt thoracic aortic injury (BTAI) in Germany was analyzed. METHODS:Prospectively collected data of patients suffering from BTAI were retrospectively analyzed with focus on the different treatment modalities for grade I-IV injuries. RESULTS:821 patients suffering from BTAI were identified: 51.6% (424) grade I injury, 35.4% (291) grade II or III injury and 12.9% (106) grade IV injury (77.5% men [44.94 ± 20.6 years]). The main patterns of injury were high- speed accidents and falls (78.0% [n = 640], 21.8% [n = 171] respectively). Significant differences between grade I and grade II/III as well as IV injuries could be assessed for the incidence of cardiopulmonary resuscitation, a Glasgow Coma Scale score below 8 and a systolic blood pressure below 90 mmHg (p-value: <0.001). In the primary admission subgroup, 44.1% (197/447) of the patients received best medical treatment, 55.9% received surgical intervention (250/447): Thereof 37.2% (93/250) received open surgery and 62.8% (147/250) had been treated by endovascular means. Significantly lower 24-h- and in-hospital-mortality rates were encountered after endovascular treatment for all gradings of BTAI (p-value: <0.001). Yet this subgroup of patients showed the lowest incidence of further severe injuries and cardiac arrest. CONCLUSION:Endovascular therapy became the treatment of choice for BTAI in Germany. Patients who have been treated by surgical means showed the highest survival rate, especially endovascular therapy showed a favorable low mortality rate.http://europepmc.org/articles/PMC5367684?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alexander Gombert Mohammad E Barbati Martin Storck Drosos Kotelis Paula Keschenau Hans-Christoph Pape Hagen Andruszkow Rolf Lefering Frank Hildebrand Andreas Greiner Michael J Jacobs Jochen Grommes |
spellingShingle |
Alexander Gombert Mohammad E Barbati Martin Storck Drosos Kotelis Paula Keschenau Hans-Christoph Pape Hagen Andruszkow Rolf Lefering Frank Hildebrand Andreas Greiner Michael J Jacobs Jochen Grommes Treatment of blunt thoracic aortic injury in Germany-Assessment of the TraumaRegister DGU®. PLoS ONE |
author_facet |
Alexander Gombert Mohammad E Barbati Martin Storck Drosos Kotelis Paula Keschenau Hans-Christoph Pape Hagen Andruszkow Rolf Lefering Frank Hildebrand Andreas Greiner Michael J Jacobs Jochen Grommes |
author_sort |
Alexander Gombert |
title |
Treatment of blunt thoracic aortic injury in Germany-Assessment of the TraumaRegister DGU®. |
title_short |
Treatment of blunt thoracic aortic injury in Germany-Assessment of the TraumaRegister DGU®. |
title_full |
Treatment of blunt thoracic aortic injury in Germany-Assessment of the TraumaRegister DGU®. |
title_fullStr |
Treatment of blunt thoracic aortic injury in Germany-Assessment of the TraumaRegister DGU®. |
title_full_unstemmed |
Treatment of blunt thoracic aortic injury in Germany-Assessment of the TraumaRegister DGU®. |
title_sort |
treatment of blunt thoracic aortic injury in germany-assessment of the traumaregister dgu®. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2017-01-01 |
description |
PURPOSE:Using the data delivered by the German Trauma Register DGU® from 2002 till 2013, the value of different therapies of blunt thoracic aortic injury (BTAI) in Germany was analyzed. METHODS:Prospectively collected data of patients suffering from BTAI were retrospectively analyzed with focus on the different treatment modalities for grade I-IV injuries. RESULTS:821 patients suffering from BTAI were identified: 51.6% (424) grade I injury, 35.4% (291) grade II or III injury and 12.9% (106) grade IV injury (77.5% men [44.94 ± 20.6 years]). The main patterns of injury were high- speed accidents and falls (78.0% [n = 640], 21.8% [n = 171] respectively). Significant differences between grade I and grade II/III as well as IV injuries could be assessed for the incidence of cardiopulmonary resuscitation, a Glasgow Coma Scale score below 8 and a systolic blood pressure below 90 mmHg (p-value: <0.001). In the primary admission subgroup, 44.1% (197/447) of the patients received best medical treatment, 55.9% received surgical intervention (250/447): Thereof 37.2% (93/250) received open surgery and 62.8% (147/250) had been treated by endovascular means. Significantly lower 24-h- and in-hospital-mortality rates were encountered after endovascular treatment for all gradings of BTAI (p-value: <0.001). Yet this subgroup of patients showed the lowest incidence of further severe injuries and cardiac arrest. CONCLUSION:Endovascular therapy became the treatment of choice for BTAI in Germany. Patients who have been treated by surgical means showed the highest survival rate, especially endovascular therapy showed a favorable low mortality rate. |
url |
http://europepmc.org/articles/PMC5367684?pdf=render |
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