GUNSHOT WOUNDS TO THE THORACIC AORTA IN THE 90S - ONLY PREVENTION WILL MAKE A DIFFERENCE

The clinical experience with gunshot injuries to the thoracic aorta at a large urban trauma center was reviewed. Of 1961 patients admitted w ith gunshot wounds to the chest, 20 sustained injuries to the thoracic aorta. Mortality occurred in 17 patients (85%), all of whom were hypo tensive or moribund upon admission. The three patients (15%) presentin g with a systolic blood pressure above 100 mm Hg survived; only one of these underwent surgery during the acute period. Only two patients we re stable enough for aortography. Advances in the management of critic ally injured patients have not improved the outcome with this lethal i njury.