Critical factors in determining mortality from abdominal aortic trauma.

Aortic injuries remain highly lethal. Major factors contributing to death in these patients appear to be free peritoneal hemorrhage and associated abdominal vascular trauma. These conditions often manifest as profound shock upon hospital presentation and portend a grim prognosis. Potential means to improve survival include: 1, vigorous resuscitation and prompt operative intervention in patients with penetrating abdominal trauma presenting in a state of shock; 2, careful search and control of associated vascular injuries prior to definitive aortic repair, and 3, constant vigilance to coagulation function, core temperature and acid-base status.