Intraabdominal vascular injury: are we getting any better? J Trauma 2010 Dec;69(6):1393-7
Date
08/10/2010Pubmed ID
20693922DOI
10.1097/TA.0b013e3181e49045Scopus ID
2-s2.0-78650804002 (requires institutional sign-in at Scopus site) 40 CitationsAbstract
BACKGROUND: Intraabdominal vascular injury (IAVI) as a result of penetrating and blunt trauma carries a high mortality rate. This study was performed to compare current mortality rates with a previously reported historic control.
METHODS: The experience at our institution from 1970 to 1981 was previously reported with an overall mortality rate of 32% in 112 patients with penetrating IAVI. In a retrospective analysis, this historic cohort was compared with 248 patients with penetrating and blunt IAVI during a 138-month interval ending in June 2007.
RESULTS: Overall mortality rate was 28.6%. The most commonly injured arteries were the iliac artery, aorta, and superior mesenteric artery. The most commonly injured veins were the inferior vena cava, iliac vein, and portal vein. Injury to the aorta, IVC, and portal vein had the highest mortality rates of 67.8%, 42.1%, and 66.6%, respectively. One hundred forty-four patients with one vessel injured had a mortality rate of 18.7%, whereas those with more than one vessel injured had a mortality rate of 48.7% (p < 0.001). A total of 46% of 117 patients in shock died compared with 9.6% of 104 patients not in shock (p < 0.001). Patients with a base deficit of less than -15 had a mortality rate of 72%, whereas those with a base deficit of 0 to -15 (p < 0.001) had a mortality rate of 18.9%. There was no difference in the overall mortality rate for penetrating trauma compared with the previous study.
CONCLUSIONS: Although over 20 years have passed, no significant changes have occurred in the mortality associated with IAVI. Patients presenting in shock with IAVI continue to have a high mortality rate.
Author List
Paul JS, Webb TP, Aprahamian C, Weigelt JAMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Chi-Square Distribution
Female
Humans
Male
Middle Aged
Registries
Retrospective Studies
Vascular System Injuries
Wisconsin
Wounds, Nonpenetrating
Wounds, Penetrating