Abdominal Aortic Trauma Outcomes in a National Trauma Database

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Emergency Medicine

Background:

• Abdominal aortic trauma (AAT) is a rare but life-threatening condition with high mortality rates.
• Surgical intervention is necessary for AAT, with open repair and endovascular aortic repair (EVAR) being the primary treatment options.

Purpose of the Study:

• To compare the outcomes of open repair versus EVAR in patients with AAT.
• To identify factors associated with mortality in AAT patients.

Main Methods:

• Retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program database (2017-2020).
• Inclusion of patients aged ≥18 years with AAT undergoing open repair or EVAR.
• Multivariable logistic regression to determine independent predictors of in-hospital mortality.

Main Results:

• Overall mortality was 47.5% among 369 AAT patients.
• Independent predictors of increased mortality included older age, low Glasgow Coma Scale, hypotension, blunt trauma, and gunshot wounds.
• EVAR was associated with significantly lower in-hospital mortality compared to open repair (aOR, 0.33; P = 0.019).

Conclusions:

• AAT carries a significant mortality risk even for patients reaching the operating room.
• EVAR is independently associated with reduced mortality in AAT patients compared to traditional open repair.