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Aortic injury in vehicular trauma
J S Williams1, J A Graff, J M Uku
1Department of Surgical Education, Memorial Medical Center, Savannah, Georgia 31403-3089.
The Annals of Thoracic Surgery
|March 1, 1994
Summary
Motor vehicle accidents frequently cause aortic injuries, particularly complete transections of the proximal descending aorta. These severe injuries, often fatal within an hour, are linked to head-on collisions and associated thoracic trauma.
Area of Science:
- Trauma Surgery
- Forensic Pathology
- Cardiovascular Research
Background:
- Aortic injuries are a significant cause of mortality in motor vehicle accidents.
- Understanding injury patterns and mechanisms is crucial for prevention and treatment.
Purpose of the Study:
- To analyze injury patterns, circumstances, and mechanisms of aortic injuries in motor vehicle fatalities.
- To identify factors influencing survival and injury characteristics.
Main Methods:
- Retrospective study of 530 motor vehicle fatalities over 5 years.
- Review of 105 aortic injuries in 90 victims.
- Analysis of accident circumstances, victim demographics, and injury types.
Main Results:
- 65% of aortic injuries were in the proximal descending aorta, predominantly transections.
- Associated injuries included multiple rib fractures (78%) and head injuries (42%).
- 94% of deaths occurred within 1 hour; 62% of accidents were head-on collisions.
- 43% of victims had a blood alcohol level exceeding 0.1 mg/dL.
Conclusions:
- Complete transections of the proximal descending aorta are common in fatal motor vehicle accidents.
- Head-on collisions and associated thoracic trauma are key factors.
- Aortic disruption may result from cardiac compression and upward thrust during impact.