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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
2
|
| pubmed:dateCreated |
1994-9-22
|
| pubmed:abstractText |
A metaanalysis of articles concerning the surgical management of acute traumatic rupture of the descending thoracic aorta published in the English-language literature between 1972 and July 1992 was performed. The overall mortality of 1,742 patients who arrived at the hospital alive was 32.0%, one-third died before surgical repair was started. Paraplegia was noted preoperatively in 2.6% of these hospitalized patients, and paraplegia complicated the surgical repair in 9.9% of 1,492 patients who reached the operating room in a relatively stable condition. Patients then were analyzed according to the surgical intervention used. Simple aortic cross-clamping (n = 443) was associated with a hospital mortality of 16.0% and incidence of paraplegia of 19.2%, despite lower average mean cross-clamp times (32 minutes; p < 0.01 versus passive or active methods of providing distal perfusion). In a subset of 290 patients in whom individual data were available, the cumulative risk of paraplegia was shown to increase substantially if the duration of aortic cross-clamping exceeded 30 minutes, but only when distal perfusion was not augmented (p < 0.00001). "Passive" perfusion shunts (n = 424) were associated with a mortality of 12.3%, and the incidence of paraplegia decreased to 11.1% (p < 0.001). However, shunts inserted from the apex of the left ventricle had a contradictory high 26.1% incidence of paraplegia compared with shunts from the ascending aorta (8.2%; p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
AIM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Aug
|
| pubmed:issn |
0003-4975
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
58
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
585-93
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:8067877-Acute Disease,
pubmed-meshheading:8067877-Aorta, Thoracic,
pubmed-meshheading:8067877-Aortic Rupture,
pubmed-meshheading:8067877-Hospital Mortality,
pubmed-meshheading:8067877-Humans,
pubmed-meshheading:8067877-Paraplegia,
pubmed-meshheading:8067877-Postoperative Complications,
pubmed-meshheading:8067877-Risk Factors
|
| pubmed:year |
1994
|
| pubmed:articleTitle |
Traumatic aortic rupture: twenty-year metaanalysis of mortality and risk of paraplegia.
|
| pubmed:affiliation |
Department of Cardiothoracic Surgery, University of Cape Town, South Africa.
|
| pubmed:publicationType |
Journal Article,
Meta-Analysis
|