BLUNT TRAUMATIC THORACIC AORTIC LACERATIONS IN THE ELDERLY - AN ANALYSIS OF OUTCOME

We found no previous work examining outcome after blunt traumatic aort ic laceration (TAL) that has focused on elderly patients (age >55 year s) with this lesion. A 20-year retrospective review from two trauma ce nters of survival outcome for patients with TAL was performed to asses s the effects of surgical therapy in the elderly cohort. Seventy-five cases were identified. Patients were assigned to one of two groups (Yo ung <55 or Old greater than or equal to 55) and data were analyzed for differences between them. There was a significantly higher mortality rate in the elderly patients (82.4% Old vs. 12.1% Young; p < 0.001). M oreover, surgical treatment in the Old group had up to a 163-fold incr eased likelihood of mortality compared with surgical treatment in the Young group (p < 0.001). We conclude that Old patients have higher mor tality associated with surgical repair of TAL. Because of the increase d risk of surgical intervention for TAL, elderly patients may be candi dates for nonsurgical management as has been advocated for patients wi th asymptomatic peripheral traumatic pseudoaneurysms.