LATERAL IMPACT MOTOR-VEHICLE COLLISIONS - SIGNIFICANT CAUSE OF BLUNT TRAUMATIC RUPTURE LOT THE THORACIC AORTA

Background: This study was undertaken to determine the relationship be tween traumatic rupture of the thoracic aorta (TRA) and the direction of impact at the time of motor vehicle crash, Methods: Retrospective r eview of TRA patients from two different databases over a 4.5-year per iod (January 1, 1991 to June 30, 1995): (1) Ontario Coroner's Office r ecords of motor vehicle deaths from Metropolitan Toronto, and (2) the trauma registries of Sunnybrook Health Science Centre and St, Michael' s Hospital in Metropolitan Toronto, Results: Ninety-seven patients (81 from the coroner's database and 16 from the adult trauma unit registr ies) sustained traumatic rupture of the thoracic aorta, Forty-eight ca ses (49.5%) were a result of lateral impact crashes, Twenty-eight driv ers (22 ipsilateral and six contralateral) and 20 passengers (16 ipsil ateral and four contralateral) sustained TRA from lateral impact crash es, Ninety-one TRAs (94%) occurred at the peri-isthmic region, Conclus ion: Lateral impact crashes are a significant cause of TRA. Traumatic rupture of the aorta should be considered with a high index of suspici on after serious lateral impact crashes, just as physicians now consid er patients at high risk of TRA after serious frontal impact crashes.