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Thoracic Spine Fractures with Blunt Aortic Injury: Incidence, Risk Factors, and Characteristics.
Hai Deng1, Ting-Xuan Tang2, Liang-Sheng Tang1
1Division of Trauma & Surgical Critical Care, Department of Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Journal of Clinical Medicine
|November 27, 2021
Summary
Blunt aortic injury (BAI) occurs in 11.3% of patients with thoracic burst fractures and is often missed. High-risk factors like severe injury, crush mechanisms, flail chest, and neurological deficits warrant suspicion for BAI.
Area of Science:
- Trauma surgery
- Orthopedic surgery
- Vascular surgery
Background:
- Coexistence of thoracic fractures and blunt aortic injury (BAI) is a critical, often overlooked, condition in trauma.
- Limited data exists on patients presenting with both thoracic fractures and BAI.
Purpose of the Study:
- To determine the incidence of BAI in patients with thoracic burst fractures.
- To identify risk factors associated with BAI in this patient population.
Main Methods:
- Prospective, observational, single-center study.
- Inclusion of 124 patients with thoracic burst fractures.
- Development of a multivariate logistic regression model to identify risk factors for aortic injury.
Main Results:
- The incidence of BAI among patients with thoracic burst fractures was 11.3% (14/124).
- A significant proportion (11/14) of BAI cases were initially missed diagnoses.
- Key risk factors for BAI included high Injury Severity Score (ISS), crush injury mechanisms, flail chest, and neurological deficits.
Conclusions:
- Blunt aortic injury is a common and frequently missed diagnosis in patients with thoracic burst fractures.
- High clinical suspicion for BAI is crucial in thoracic burst fracture patients exhibiting specific high-risk factors.
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