Evaluation of patients diagnosed with acute blunt aortic injury and their bedside plain chest radiography in the emergency department: A retrospective study

BACKGROUND: The purpose of our study was to retrospectively evaluate traumatic aortic transection patients and their bedside plain chest radiographs for signs of aortic injury.
METHODS: Emergency department (ED) patients from a 5-year period with traumatic aortic transection who were over 18 years of age were included in the study. Demographic characteristics, mechanism of trauma, Revised Trauma Score, Glasgow Coma Score, vital signs, physical exam findings, laboratory parameters, length of stay in the ED, and patient outcomes were documented. Bedside plain chest radiograph images were interpreted by 2 emergency medicine specialists and 1 radiologist.
RESULTS: Thirty patients, mean age 45.87±16.14 years (70% male), were enrolled. Most common trauma mechanism was motor vehicle accident (53.3%). Agreement rates between emergency medicine specialists and radiologist were found to be “excellent” and “substantial” in identifying mediastinal widening and multiple left sided rib fractures; and “fair” in identifying widened paraspinal line, and transthoracic vertebral fractures.
CONCLUSION: Though not completely reliable, bedside plain chest radiographs and physical examination findings may be useful in detecting aortic injury during primary survey when the patient is unstable and cannot be sent for chest computerized tomography. Appropriate further imaging studies should be carried out as appropriate based on patient’s hemodynamic status.

Acil serviste akut künt travmatik aortik yaralanma tanýsý alan olgularýn geriye dönük incelenmesi ve yatakbaþý akciðer grafi görüntülerinin deðerlendirilmesi

AMAÇ: Akut künt travmatik aortik yaralanmasý ile baþvuran olgularýn geriye dönük olarak incelenmesi ve yatakbaþý akciðer grafisinde muhtemel aortik yaralanmaya ait bulgularýnýn deðerlendirilmesi amaçlandý.
GEREÇ VE YÖNTEM: Beþ yýllýk dönemde 18 yaþ üstü akut travmatik aort transeksiyonu tanýlý hastanýn dosyalarý geriye dönük olarak incelendi. Demografik özellikleri, olayýn niteliði, revise travma skoru, Glaskow koma skalasý, vital bulgularý, fizik muayene bulgularý, biyokimyasal parametreleri, acilde kalýþ süreleri, olgularýn takip sonucu ve yatakbaþý çekilen akciðer grafisi iki acil týp uzmaný ve bir radyolog tarafýndan deðerlendirildi.
BULGULAR: Çalýþmaya 30 olgu alýndý. Yaþ ortalamasý 45.87±16.14 (%70 erkek) ve en sýk nedeni araçiçi trafik kazasý (%53.3) idi. Acil týp uzmanlarý ve radyolog uyumu mediastinal geniþlemesi ve sol seri kot kýrýklarýnda ‘mükemmel-kabul edilebilir’, paraspinal hattýn geniþlemesi ve torasik vertebra kýrýðýnda ‘zayýf’ olarak tespit edildi.
TARTIÞMA: Akut künt travmatik aortik yaralanma primer bakýda fizik muayene ve akciðer grafisi resüsitasyon için fikir verebilir. Ýkincil baký için hastanýn hemodinamik stabilitesi ve yaralanma mekanizmalarý da gözönüne alýnarak uygun görüntüleme stratejileri belirlenmelidir.