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Atypical profile of aortic injury associated with blunt trauma in the metropolitan area of Japan
  1. Shusuke Mori1,
  2. Tomohiko Ai1,2,
  3. Yasuhiro Otomo1
  1. 1Trauma and Acute Critical Care Center, Tokyo Medical and Dental University, Tokyo, Japan
  2. 2Indiana University School of Medicine, Indianapolis, Indiana, USA
  1. Correspondence to Dr Shusuke Mori, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; shunasu{at}yahoo.co.jp

Abstract

Background Aortic injury caused by blunt trauma is a critical medical condition that requires extraordinary caution in the treatment. It is often caused by direct hit and high-speed deceleration in motor vehicle accidents. We reviewed and analysed the cases of aortic injury that referred to our institution located in the midst of the metropolitan area of Tokyo, Japan.

Methods We retrospectively reviewed the blunt trauma cases transferred to Tokyo Medical and Dental University Hospital in the past 10 years. All cases with aortic injury were analyzed regardless of the AIS scores. Results: Between 2007 and 2017, a total of 3500 blunt trauma cases were transferred. Nineteen cases showed aortic injuries associated with blunt trauma (Age: 63.5±15.6 y.o.; 15 males). Thirteen patients were injured by fall, four patients were senior pedestrians hit by cars, one was injured while riding a motor bike, and one was hit by a train. A total of 11 cases presented a cardiopulmonary arrest on arrival; 8 severe aortic injuries, 1 cardiac rupture; and 2 multiple injuries. Eight cases were alive on arrival; 3 Stanford type A aortic dissections, 3 Stanford type B aortic dissections, and 2 aortic ruptures. Two cases of Stanford type A dissection underwent emergency repairs, whereas all 3 type B dissections went on a good course with conservative treatment.

Conclusions Aortic injury caused by blunt trauma seems to be rare in a metropolitan area in Japan. In addition, the leading cause in our cases was fall, which might be a rare cause of aortic injuries in the other countries. Our observation might be a manifestation of population aging.

  • blunt trauma
  • thoracic aorta
  • fall
  • traffic accidents

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Presented at This study was presented at 4th World Trauma Congress 2018 at San Diego, CA, September 26–29, 2018.

  • Contributors SM: study conception, design, interpretation, and drafting of article. TA: interpretation and drafting of article. YO: study conception and supervision of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement statement Not required.

  • Patient consent for publication Obtained.

  • Ethics approval This study was performed in accordance with the guidelines of researches of human subjects in Tokyo Medical and Dental University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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