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Association of traumatic brain injury with management and outcomes of patients with blunt thoracic aortic injury
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Association of traumatic brain injury with management and outcomes of patients with blunt thoracic aortic injury
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Journal Article
Association of traumatic brain injury with management and outcomes of patients with blunt thoracic aortic injury
2025
Overview
30% of patients with blunt thoracic aortic injury (BTAI) can have concomitant traumatic brain injury (TBI), with mortality nearing 20%. Conflicting blood pressure goals may influence decision and timing of thoracic endovascular aortic repair (TEVAR). This study analyzed management and outcomes in patients with concomitant TBI/BTAI.
Patients with concomitant TBI/BTAI and BTAI were identified in our trauma registry. Descriptive statistics and logistic regression compared management and outcomes.
Twenty patients had concomitant TBI/BTAI. 46 patients had BTAI alone. 9(13%) patients with concomitant TBI/BTAI and 30(45%) patients with BTAI alone underwent TEVAR. There was no difference in overall mortality (OR 0.29, 0.05–1.55 CI, p = 0.12), aortic-related mortality (x2 3.51, p = 0.06), incidence of TEVAR (x2 1.59, p = 0.10) or timing to TEVAR (t = −1.6056, p = 0.06) between patients with concomitant TBI/BTAI and BTAI alone.
There was no difference in outcomes or interventions in patients with TBI/BTA vs BTAI alone in this small, hypothesis-generating single institutional trial.
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•Concomitant TBI/BTAI has a mortality around 20%.•Conflicting optimal blood pressure exists - higher for TBI, lower for BTAI.•BTAI repair should be considered in patients with concomitant TBI.•A larger multi-institutional trial is needed.
Publisher
Elsevier Inc,Elsevier Limited
Subject
/ Aged
/ Aorta
/ Blunt thoracic aortic injury
/ Brain
/ Brain Injuries, Traumatic - complications
/ Brain Injuries, Traumatic - mortality
/ Female
/ Humans
/ Male
/ Patients
/ Thoracic Injuries - complications
/ Thorax
/ Trauma
/ Vascular System Injuries - complications
/ Vascular System Injuries - mortality
/ Vascular System Injuries - surgery
/ Wounds, Nonpenetrating - complications
