Major vascular injuries of the torso

We reviewed autopsy data from 802 trauma deaths in northwestern Louisiana from January 1983 to March 1988 and found that 18% of all such deaths involved noncardiac major vascular injuries of the torso. Ninety-four percent of all deaths from blunt trauma and 45% of all deaths from penetrating trauma involved injury to the aorta, either thoracic or abdominal. Injuries to the thoracic aorta accounted for 11% of all trauma-related deaths in northwestern Louisiana; 68% of all victims died at the scene of the trauma. During this period 57 patients with noncardiac major vascular injuries of the torso were treated at the LSU-Shreveport Medical Center. Fifteen (26%) of these patients were transported to LSU-SMC from neighboring rural parishes outside the Shreveport-Bossier City metropolitan area. The mortality was 37%, and there was no difference in survival between those patients transported to LSU-SMC from within the Shreveport-Bossier City area and those transported from the rural parishes. Multivariate analysis of data showed that survival was determined by the complexity of the injury, the patient's ability to reach the hospital, and the stability of the patient's condition on arrival at the hospital. Transport time did not appear to affect survival.