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Evidence summaries

Transesophageal Echocardiography for Diagnosis of Traumatic Aortic Injury

Transesophageal echocardiography is an accurate first-line investigation in patients with suspected traumatic aortic injury. Level of evidence: "A"

A systematic review 1 including 7 studies with a total of 812 subjects was abstracted in DARE. Studies presenting the results of patient surgery, necropsy or clinical follow-up to confirm diagnosis were eligible for inclusion. The included studies compared TEE with aortography, helical computed tomography scan or serum creatine-kinase monoclonal antibodies values. Aortography was described as the 'gold' standard. The sensitivity of TEE ranged from 56 to 99% and the specificity from 89 to 99%; the area under the ROC curve for all studies was 0.95, indicating good diagnostic test accuracy. The maximum joint sensitivity and specificity for all studies was 97%.

Comment: The authors state that no standard of care can be drawn from the current evidence because of the lack of randomised controlled trials.

    References

    • Cinnella G, Dambrosio M, Brienza N, Tullo L, Fiore T. Transesophageal echocardiography for diagnosis of traumatic aortic injury: an appraisal of the evidence. J Trauma 2004 Dec;57(6):1246-55. [PubMed] [DARE]

Primary/Secondary Keywords