430 Experience of Blunt Aortic Injury at a Major Trauma Centre: A Retrospective, Single-Centre Study

Aim To determine the profile and outcomes of patients with Blunt Aortic Injury (BAI) admitted to a large volume UK major trauma centre. Method This was a retrospective review of patients identified admitted with BAI between November 2017 and February 2023. Primary outcomes were mortality rate and whether they were managed conservatively, required endovascular or open intervention or both. Descriptive statistics are reported. Results Of the 45 patients identified, 36 (80%) were male and median age was 39 (IQR 24-57). The median injury severity score (ISS) was 36 (IQR 29-41). 90-day mortality rate was 20%, with a mortality rate of 18% at 36-hours post traumatic injury. 67% (n=30) were managed conservatively, 3 (7%) did not survive initial resuscitation and therefore no management plan was created. Of the remaining patients who were managed operatively, 12 (27%) were managed with a thoracic endovascular aortic repair (TEVAR). The median time to first intervention was 1.9 days (range 0-4.5 days). Conclusions Blunt aortic injuries carry a significant mortality risk in polytrauma patients with an already substantial burden of injury. BAI affecting the thoracic aorta tend to be more common than blunt abdominal aortic injury. The management of BAI is complex and multifactorial. Further work should include organising a multi-centre study to increase the sample size allowing the comparison of BAI and their management in different centres across the UK. This could help create a national recommendation for managing such injuries.