{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:22:30Z","timestamp":1790414550295,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T00:00:00Z","timestamp":1577664000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["RO\u20101 1 R01\/CE001589\u201001"],"award-info":[{"award-number":["RO\u20101 1 R01\/CE001589\u201001"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In the era of frequent head\u2010to\u2010pelvis computed tomography (CT) for adult blunt trauma evaluation, we sought to update teachings regarding aortic injury by determining 1) the incidence of aortic injury; 2) the proportion of patients with isolated aortic injury (without other concomitant thoracic injury); 3) the clinical implications of aortic injury (hospital mortality, length of stay [LOS], and rate of surgical interventions); and 4) the screening value of traditional risk factors\/markers (such as high\u2010energy mechanism and widened mediastinum on chest x\u2010ray [CXR]) for aortic injury, compared to newer criteria from the recently developed NEXUS Chest CT decision instrument (DI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a preplanned analysis of patients prospectively enrolled in the NEXUS Chest studies at 10 Level I trauma centers with the following inclusion criteria: age &gt; 14\u00a0years, blunt trauma within 6\u00a0hours of ED presentation, and receiving chest imaging during\u00a0ED trauma evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 24,010 enrolled subjects, 42 (0.17%, 95% confidence interval [CI]\u00a0= 0.13% to 0.24%) had aortic injury. Most patients (79%, 95% CI\u00a0= 64% to 88%) had an associated thoracic injury, with rib fractures, pneumothorax\/hemothorax, and pulmonary contusion occurring most frequently. Compared to patients without aortic injury this cohort had similar mortality (9.5%, 95% CI\u00a0= 3.8% to 22.1% vs. 5.8%, 95% CI\u00a0= 5.4% to 6.3%), longer median hospital LOS (11\u00a0days vs. 3\u00a0days, p\u00a0&lt;\u00a00.01), and higher median Injury Severity Score (29 vs. 5, p\u00a0&lt;\u00a00.001). High\u2010energy mechanism and widened mediastinum on CXR had low sensitivity for aortic injury (76% [95% CI\u00a0= 62% to 87%] and 33% [95% CI\u00a0= 21% to 49%], respectively), compared to the NEXUS Chest CT DI (sensitivity 100% [95% CI\u00a0= 92% to 100%]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Aortic injury is rare in adult ED blunt trauma patients who survive to receive imaging. Most ED aortic injury patients have associated thoracic injuries and survive to hospital discharge.\u00a0Widened mediastinum on CXR and high\u2010energy mechanism have relatively low screening sensitivity for aortic injury, but the NEXUS Chest DI detected all cases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13900","type":"journal-article","created":{"date-parts":[[2019,12,7]],"date-time":"2019-12-07T12:55:50Z","timestamp":1575723350000},"page":"291-296","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Blunt Traumatic Aortic Injury in the Pan\u2010scan Era"],"prefix":"10.1111","volume":"27","author":[{"given":"Louis","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine The University of California at San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte 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California at San Diego School of Medicine La Jolla CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre R.","family":"Anglin","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Keck School of Medicine University of Southern California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory W.","family":"Hendey","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of California at Los Angeles Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Nishijima","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of California at Davis School of Medicine Orange CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1354-1773","authenticated-orcid":false,"given":"Robert 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