{"title":"Morphology and Risk Factors for Blunt Aortic Trauma in Car Accidents - An Autopsy Study","authors":"Ticijana Prijon, Branko Ermenc","volume":92,"journal":"International Journal of Law and Political Sciences","pagesStart":488,"pagesEnd":492,"ISSN":"1307-6892","URL":"https:\/\/publications.waset.org\/pdf\/9999082","abstract":"<p>Background: Blunt aortic trauma (BAT) includes<br \/>\r\nvarious morphological changes that occur during deceleration,<br \/>\r\nacceleration and\/or body compression in traffic accidents. The<br \/>\r\nvarious forms of BAT, from limited laceration of the intima to<br \/>\r\ncomplete transection of the aorta, depends on the force acting on the<br \/>\r\nvessel wall and the tolerance of the aorta to injury. The force depends<br \/>\r\non the change in velocity, the dynamics of the accident and of the<br \/>\r\nseating position in the car. Tolerance to aortic injury depends on the<br \/>\r\nanatomy, histological structure and pathomorphological alterations<br \/>\r\ndue to aging or disease of the aortic wall.<br \/>\r\nAn overview of the literature and medical documentation reveals<br \/>\r\nthat different terms are used to describe certain forms of BAT, which<br \/>\r\ncan lead to misinterpretation of findings or diagnoses. We therefore,<br \/>\r\npropose a classification that would enable uniform systematic<br \/>\r\nscreening of all forms of BAT. We have classified BAT into three<br \/>\r\nmorphologycal types: TYPE I (intramural), TYPE II (transmural) and<br \/>\r\nTYPE III (multiple) aortic ruptures with appropriate subtypes.<br \/>\r\nMethods: All car accident casualties examined at the Institute of<br \/>\r\nForensic Medicine from 2001 to 2009 were included in this<br \/>\r\nretrospective study. Autopsy reports were used to determine the<br \/>\r\noccurrence of each morphological type of BAT in deceased drivers,<br \/>\r\nfront seat passengers and other passengers in cars and to define the<br \/>\r\nmorphology of BAT in relation to the accident dynamics and the age<br \/>\r\nof the fatalities.<br \/>\r\nResults: A total of 391 fatalities in car accidents were included in<br \/>\r\nthe study. TYPE I, TYPE II and TYPE III BAT were observed in<br \/>\r\n10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in<br \/>\r\ndrivers, front seat and other passengers was 36,7%, 43,1% and<br \/>\r\n28,6%, respectively. In frontal collisions, the incidence of BAT was<br \/>\r\n32,7%, in lateral collisions 54,2%, and in other traffic accidents<br \/>\r\n29,3%. The average age of fatalities with BAT was 42,8 years and of<br \/>\r\nthose without BAT 39,1 years.<br \/>\r\nConclusion: Identification and early recognition of the risk factors<br \/>\r\nof BAT following a traffic accident is crucial for successful treatment<br \/>\r\nof patients with BAT. Front seat passengers over 50 years of age who<br \/>\r\nhave been injured in a lateral collision are the most at risk of BAT.<\/p>\r\n","references":"[1] Moar JJ. Traumatic rupture of the thoracic aorta. An autopsy and\r\nhistopathological study. S Afr Med J 1985;6:383-385.\r\n[2] Ben-Menachem Y, Handel SF. The mechanism of injury. Angiography\r\nin trauma. A work atlas. London: WB Saunders, 1981.\r\n[3] Richens D, Field M, Neale M, Oakley C. The mechanism of injury in\r\nblunt traumatic rupture of the aorta. Eur J CardiothoracSurg\r\n2002;21:288-293.\r\n[4] Sevitt S. The mechanisms of traumatic rupture of the thoracic aorta. Br J\r\nSurg 1977;64:166-173.\r\n[5] PierangeliA et al. 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