Noncorrelation between thoracic skeletal injuries and acute traumatic aortic tear

被引:28
作者
Lee, J
Harris, JH
Duke, JH
Williams, JS
机构
[1] UNIV TEXAS,SCH MED,DEPT RADIOL,HOUSTON,TX 77030
[2] UNIV TEXAS,SCH MED,DEPT SURG,HOUSTON,TX 77030
[3] UNIV TENNESSEE,MED CTR,DEPT RADIOL,MEMPHIS,TN
关键词
acute traumatic aortic tear; injury; pseudoaneurysm; skeletal; rib fracture; chest radiograph; predictive value; correlation; blunt trauma;
D O I
10.1097/00005373-199709000-00002
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
It is generally accepted that the presence of thoracic skeletal injuries has a predictive value for acute traumatic aortic tear (ATAT). The purpose of this study is to objectively assess the validity of that premise. The initial chest radiographs of 548 patients who underwent aortic angiography for suspected ATAT were reviewed for thoracic skeletal injuries, The incidence of thoracic skeletal injuries was compared between patients with and without angiographically confirmed ATAT. Rib fracture is the only thoracic skeletal injury whose incidence is statistically significantly higher in patients with ATAT (36 of 62, 58.1%) than in those without (207 of 486, 42.6%) (p = 0.0209), The positive predictive value of rib fractures in evaluating ATAT, however, is 14.8%, a rate similar to the incidence of ATAT at most trauma centers, and the specificity is 57.4%, The second most common finding in patients with ATAT, the absence of thoracic skeletal injury, is not statistically:significantly different between patients with ATAT (24 of 62, 38.7%) and those without (220 of 486, 45.3%) (p = 0.3279). We conclude that (1) there is no clinically relevant correlation between thoracic skeletal injuries and ATAT, and (2) selection of patients requiring thoracic aortography must be based on appropriate mechanism of injury and radiographic evidence of mediastinal hematoma.
引用
收藏
页码:400 / 404
页数:5
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