Traumatic rupture of the aorta

The aim of this study was to determine the incidence and mortality from traumatic ruptures of thoracic aortas (TAR) in a well defined population over a 7 year period. The study provides a retrospective analysis of case files of all deaths from road traffic accidents and falls from heights, the usual causes of TAR, filed in the Forensic Medicine Unit of the Pathology Department of the University of Edinburgh, for Lothian and Borders Region. Of the 276 fatal road traffic collisions and falls from heights identified in archival material, 66 traumatic aortic ruptures were found in the period between 1988 and 1994. Only 11% of these patients were alive on arrival to a hospital or an emergency department. To decrease the high mortality rate the following are required: an earlier, more sustained and vigorous, on site resuscitation; efficient screening methods for the diagnosis of TAR in multi-traumatised patients; identification of the specific characteristics of those traumatic episodes which are likely to be associated with a high risk of rupture, and an increase in the number of surgical interventions for ruptured aortas.