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Aortic transection: demographics, treatment and outcomes in Victoria, Australia
  1. Ryan J Hiller1,
  2. Antonina A Mikocka-Walus1,
  3. Peter A Cameron1,2
  1. 1Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  2. 2Emergency and Trauma Centre, the Alfred Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Antonina A Mikocka-Walus, Department of Epidemiology and Preventive Medicine, Monash University, 89 Commercial Road, Melbourne 3004, Victoria, Australia; antonina.mikocka-walus{at}med.monash.edu.au

Abstract

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.

  • Aortic transaction
  • epidemiology
  • major trauma management
  • mortality
  • outcomes
  • trauma

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Footnotes

  • Funding The Victorian State Trauma Registry (VSTR) is a funded and approved initiative of the Department of Human Services and TAC Health Research.

  • Competing interests None.

  • Ethics approval Ethics and institutional approval for VSTR has been granted by the Monash University Standing Committee on Ethics in Research Involving Humans and from the Human Research Ethics Committee of each participating institution.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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