Deceleration energy and change in velocity on impact:​ key factors in fatal versus potentially survivable motor vehicle crash (MVC) aortic injuries (AI):​ the role of associated injuries as determinants of outcome

Siegel, John H.; Smith, Joyce A.; Tenenbaum, Nadegda; McCammon, Laurie; Siddiqi, Shabana Q.; Presswalla, Faruk; Pierre-Louis, Phito; Williams, Wayne; Zaretski, Leonard; Hutchins, Kenneth; Perez, Lyla; Shaikh, J.; Natarajan, Geetha

Objective: To examine the difference in force mechanisms between fatal and potentially survivable MVC aortic injuries (AI) compared to non-AI severe thoracic injuries (ST).

Methods: Of 324 autopsied MVC driver or front seat passenger fatalities (1997-2000), there were 43 fatal AI (36 scene deaths, 7 hospital deaths) and 5 additional AI survivors.

Results: Of the 48 AI, there was only a 42% survival for those reaching hospital alive. 80% of AI survivors had isthmus lesions and all had no or minimal brain injury (GCS >= 13), no cardiac injury and only 20% ribs 1-4 fx or shock; of AI non-survivors reaching hospital alive, 67% had GCS <= 12, 50% cardiac injury,

Year

Entry

1971

Nahum AM, Gadd CW, Schneider DC, Kroell CK. The biomechanical basis for chest impact protection: force-deflection characteristics of the thorax. J Trauma. October 1971;11(10):874-882.

1988

Dischinger PC, Cowley RA, Shankar BS, Smialek JE. The incidence of ruptured aorta among vehicular fatalities. In: 32nd Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 12-14, 1988; Seattle, WA.15-23.

1997

Katyal D, McLellan BA, Brenneman FD, Boulanger BR, Sharkey PW, Waddell JP. Lateral impact motor vehicle collisions: significant cause of blunt traumatic rupture of the thoracic aorta. J Trauma. May 1997;42(5):769-772.

1976

Eppinger RH. Prediction of thoracic injury using measurable experimental parameters. In: Proceedings of the 6th International Technical Conference on Experimental Safety Vehicles (ESV). October 12-15, 1976; Washington, D.C.770-780.

1978

Viano DC, Haut RC, Golocovsky M, Absolon K. Factors influencing biomechanical response and closed chest trauma in experimental thoracic impacts. In: 22nd Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). July 10-14, 1978; Ann Arbor, MI.67-82.