National trends in utilization and outcome of thoracic endovascular aortic repair for traumatic thoracic aortic injuries

Abstract Introduction Endovascular repair of traumatic thoracic aortic injuries (TTAI) is an alternative to conventional open surgical repair. Single institution studies have shown a survival benefit with TEVAR, but it is not clear if this is being realized nationally. The purpose of our study was to document trends in the increase in utilization of TEVAR and its impact on outcomes of TTAI nationally. Methods Patients admitted with a traumatic thoracic aortic injury between 2005 and 2011 were identified in the National Inpatient Sample (NIS). Patients were grouped by treatment into TEVAR, open repair, or nonoperative management groups. Primary outcomes were relative utilization over time and in-hospital mortality. Secondary outcomes included postoperative complications and length of stay. Multivariable logistic regression was performed to identify independent predictors of mortality. Results A total of 8384 patients were included, with 2492 (29.7%) undergoing TEVAR, 848 (10.1%) open repair, and 5044 (60.2%) managed nonoperatively. TEVAR has b