Thoracic aortic injury in Japan--nationwide retrospective cohort study.
The epidemiology of traumatic thoracic aortic injury has not been reported in many countries, so we investigated the current trends in Japan. Patients with traumatic thoracic aortic injury from July 2007 to March 2013 were identified using a Japanese nationwide administrative database, the Diagnosis Procedure Combination inpatient database. The trends in crude in-hospital mortality and proportion of endovascular repair use among patients with repair were evaluated over time. A total of 617 incident cases of thoracic aortic injury were identified at 234 hospitals, and categorized into endovascular repair (n=126), open repair (n=76), and non-repair (n=415) groups. The in-hospital mortality rate for each of these groups was 5.6%, 15.8%, and 45.3%, respectively. The in-hospital survival rate was higher in the endovascular repair group than in the open repair group (log-rank χ(2)=4.9; P=0.03). Although the crude in-hospital mortality did not change significantly during the study period (Mantel-Haenszel trend test, P=0.10), the proportion of endovascular repair use among all repair cases increased significantly (P<0.001). The results of the present nationwide study suggest that the endovascular approach to treatment of thoracic aortic injury in Japan gained in popularity from 2007 to 2012.