Outcome Following Non-Operative Management in Blunt Aortic Trauma

Sadia Ilyas; Akpofure Peter Ekeh; D. L. Conley; Ronald J. Markert; Mark P. Anstadt

Outcome Following Non-Operative Management in Blunt Aortic Trauma

Sadia Ilyas, Akpofure Peter Ekeh, D. L. Conley, Ronald J. Markert, Mark P. Anstadt

Research output: Contribution to conference › Poster

Abstract

Purpose: Aortic injury following blunt trauma is an indication for urgent thoracic aortic repair. Reports from centers using thoracic endografts have suggested that the strategy of delayed aortic repair can improve survival in these patients. Experience has also demonstrated that non-operative management without aortic repair is appropriate in selected patients. The purpose of this study was to determine the outcome of patients with blunt aortic injury managed non-operatively.

Methods: All patients admitted to a single institution Level I trauma center were prospectively enrolled in a registry. Those patients identified with blunt aortic injury that were managed non-operatively between January 2005 to December 2010 were reviewed. In-hospital mortality, length of stay and survival following discharge were assessed in this patient cohort.

Results: A total of 53 patients were identified with blunt aortic injury during the study period. Thirty of the patients were managed operatively; 17 underwent open repair and 13 endovascular repair. Twenty-four patients (45%) were managed non-operatively and underwent further analysis. The male to female ratio was 15:8 with an average age of 44 (range 18-85) years. In hospital mortality occurred in only 1 patient (4%) managed non-operatively. This patient expired in the first 24 hours due to multiple co-morbidities and extensive associated traumatic injuries. The mean length of hospital stay in the remaining 23 survivors was 20 days. Follow-up was available in 22 of 23 patients following discharge. All patients were alive at the last time of contact, mean 19 (range 1 to 67) months.

Conclusions: Improved survival with endografts for blunt aortic injury is felt related to strategies of delayed repair. The present study demonstrates patients can be managed medically with excellent survival. Therefore, when considering delayed aortic repair for blunt aortic injury, medical management should be considered in selected patients.

Original language	American English
State	Published - Jan 29 2012
Event	48th STS Annual Meeting and Exhibition - Fort Lauderdale, United States Duration: Jan 28 2012 → Feb 1 2012 Conference number: 48

Conference

Conference	48th STS Annual Meeting and Exhibition
Country/Territory	United States
City	Fort Lauderdale
Period	1/28/12 → 2/1/12

Disciplines

Surgery

Cite this

@conference{167f4409a82b4156821073c8279ac63b,

title = "Outcome Following Non-Operative Management in Blunt Aortic Trauma",

abstract = " Purpose: Aortic injury following blunt trauma is an indication for urgent thoracic aortic repair. Reports from centers using thoracic endografts have suggested that the strategy of delayed aortic repair can improve survival in these patients. Experience has also demonstrated that non-operative management without aortic repair is appropriate in selected patients. The purpose of this study was to determine the outcome of patients with blunt aortic injury managed non-operatively. Methods: All patients admitted to a single institution Level I trauma center were prospectively enrolled in a registry. Those patients identified with blunt aortic injury that were managed non-operatively between January 2005 to December 2010 were reviewed. In-hospital mortality, length of stay and survival following discharge were assessed in this patient cohort. Results: A total of 53 patients were identified with blunt aortic injury during the study period. Thirty of the patients were managed operatively; 17 underwent open repair and 13 endovascular repair. Twenty-four patients (45%) were managed non-operatively and underwent further analysis. The male to female ratio was 15:8 with an average age of 44 (range 18-85) years. In hospital mortality occurred in only 1 patient (4%) managed non-operatively. This patient expired in the first 24 hours due to multiple co-morbidities and extensive associated traumatic injuries. The mean length of hospital stay in the remaining 23 survivors was 20 days. Follow-up was available in 22 of 23 patients following discharge. All patients were alive at the last time of contact, mean 19 (range 1 to 67) months. Conclusions: Improved survival with endografts for blunt aortic injury is felt related to strategies of delayed repair. The present study demonstrates patients can be managed medically with excellent survival. Therefore, when considering delayed aortic repair for blunt aortic injury, medical management should be considered in selected patients.",

author = "Sadia Ilyas and Ekeh, {Akpofure Peter} and Conley, {D. L.} and Markert, {Ronald J.} and Anstadt, {Mark P.}",

year = "2012",

month = jan,

day = "29",

language = "American English",

note = "48th STS Annual Meeting and Exhibition ; Conference date: 28-01-2012 Through 01-02-2012",

}

TY - CONF

T1 - Outcome Following Non-Operative Management in Blunt Aortic Trauma

AU - Ilyas, Sadia

AU - Ekeh, Akpofure Peter

AU - Conley, D. L.

AU - Markert, Ronald J.

AU - Anstadt, Mark P.

N1 - Conference code: 48

PY - 2012/1/29

Y1 - 2012/1/29

N2 - Purpose: Aortic injury following blunt trauma is an indication for urgent thoracic aortic repair. Reports from centers using thoracic endografts have suggested that the strategy of delayed aortic repair can improve survival in these patients. Experience has also demonstrated that non-operative management without aortic repair is appropriate in selected patients. The purpose of this study was to determine the outcome of patients with blunt aortic injury managed non-operatively. Methods: All patients admitted to a single institution Level I trauma center were prospectively enrolled in a registry. Those patients identified with blunt aortic injury that were managed non-operatively between January 2005 to December 2010 were reviewed. In-hospital mortality, length of stay and survival following discharge were assessed in this patient cohort. Results: A total of 53 patients were identified with blunt aortic injury during the study period. Thirty of the patients were managed operatively; 17 underwent open repair and 13 endovascular repair. Twenty-four patients (45%) were managed non-operatively and underwent further analysis. The male to female ratio was 15:8 with an average age of 44 (range 18-85) years. In hospital mortality occurred in only 1 patient (4%) managed non-operatively. This patient expired in the first 24 hours due to multiple co-morbidities and extensive associated traumatic injuries. The mean length of hospital stay in the remaining 23 survivors was 20 days. Follow-up was available in 22 of 23 patients following discharge. All patients were alive at the last time of contact, mean 19 (range 1 to 67) months. Conclusions: Improved survival with endografts for blunt aortic injury is felt related to strategies of delayed repair. The present study demonstrates patients can be managed medically with excellent survival. Therefore, when considering delayed aortic repair for blunt aortic injury, medical management should be considered in selected patients.

AB - Purpose: Aortic injury following blunt trauma is an indication for urgent thoracic aortic repair. Reports from centers using thoracic endografts have suggested that the strategy of delayed aortic repair can improve survival in these patients. Experience has also demonstrated that non-operative management without aortic repair is appropriate in selected patients. The purpose of this study was to determine the outcome of patients with blunt aortic injury managed non-operatively. Methods: All patients admitted to a single institution Level I trauma center were prospectively enrolled in a registry. Those patients identified with blunt aortic injury that were managed non-operatively between January 2005 to December 2010 were reviewed. In-hospital mortality, length of stay and survival following discharge were assessed in this patient cohort. Results: A total of 53 patients were identified with blunt aortic injury during the study period. Thirty of the patients were managed operatively; 17 underwent open repair and 13 endovascular repair. Twenty-four patients (45%) were managed non-operatively and underwent further analysis. The male to female ratio was 15:8 with an average age of 44 (range 18-85) years. In hospital mortality occurred in only 1 patient (4%) managed non-operatively. This patient expired in the first 24 hours due to multiple co-morbidities and extensive associated traumatic injuries. The mean length of hospital stay in the remaining 23 survivors was 20 days. Follow-up was available in 22 of 23 patients following discharge. All patients were alive at the last time of contact, mean 19 (range 1 to 67) months. Conclusions: Improved survival with endografts for blunt aortic injury is felt related to strategies of delayed repair. The present study demonstrates patients can be managed medically with excellent survival. Therefore, when considering delayed aortic repair for blunt aortic injury, medical management should be considered in selected patients.

UR - https://corescholar.libraries.wright.edu/surg/71

M3 - Poster

T2 - 48th STS Annual Meeting and Exhibition

Y2 - 28 January 2012 through 1 February 2012

ER -

Outcome Following Non-Operative Management in Blunt Aortic Trauma

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