Thoracic aortic transection treated by thoracic endovascular aortic repair: predictors of survival

We reviewed all patients presenting to our institution with a traumatic thoracic aortic injury (TTAI) between January 2006 and May 2007. Age, gender, injury severity score (ISS), location of injuries, surgical intervention, and length of stay were assessed to determine what characteristics might be predictive of survival. Of the 56 patients who were identified, 23 (41%) were dead on arrival, 15 (20%) died on that admission, and 18 (32%) survived to discharge. Injury severity score was elevated in mortalities (57) compared to survivors (34). Penetrating and blunt aortic injuries had 89% and 58% mortality rates, respectively. Female gender was associated with increased survival (P = .032), as was receiving surgical intervention (P = .03). Patients with a prolonged ICU stay demonstrated increased survival. All eight patients who received thoracic endovascular aortic repair survived to discharge. Injury severity score, mechanism, thoracic endovascular aortic repair (TEVAR), female gender, and surgical treatment were associated with survival after TTAI.