Civilian vascular trauma, treatment and outcome at a level 1-trauma centre.
Blunt
Injury score
Mortality
Penetrating
Scandinavian
Treatment
Vascular trauma
Journal
Scandinavian journal of trauma, resuscitation and emergency medicine
ISSN: 1757-7241
Titre abrégé: Scand J Trauma Resusc Emerg Med
Pays: England
ID NLM: 101477511
Informations de publication
Date de publication:
21 Dec 2022
21 Dec 2022
Historique:
received:
29
08
2022
accepted:
30
11
2022
entrez:
21
12
2022
pubmed:
22
12
2022
medline:
24
12
2022
Statut:
epublish
Résumé
Outcomes after vascular injuries in wartime are well documented, but studies on vascular injuries in a civilian European populations are scarce. A retrospective study on all adults admitted to a North-European level 1-trauma centre 2009-2018 with The Abbreviated Injury Scale-codes for non-iatrogenic vascular trauma (VT). Data were extracted from both national and regional trauma-registries, as well as patient charts. Patient demographics, mechanism, and location of vascular injury were registered as well as its treatment. Incidence and injury scores (ISS, NISS and TRISS) were calculated and overall survival (Kaplan-Meier) estimated. Of 4042 trauma-patients, 68 (1.7%) (median age 44 years, 76% males) sustained 81 vascular injuries (69 arterial; 12 venous); 46 blunt and 22 (32%) penetrating injuries. The total incidence of vascular injuries was 1.45/100,000 inhabitants and did not change over the study-period (95% confidence interval 1.13-1.82). The injuries were located in thorax (n = 17), neck (n = 16) and abdominal region (n = 15); most of the blunt injuries followed traffic (n = 31) or falling accidents (n = 10), and with 17 of the 22 penetrating injuries due to stabbing. The median ISS and NISS-scores were 22 and 33, with 50 (74%) and 55 (81%) patients having scores > 15, respectively. Forty-three (63%) patients had open surgical repair and 8 (12%) received endovascular treatment. Twenty-one patients died within 30-days (31%), 33% and 27% after blunt and penetrating injuries, respectively. Half of the patients that died within 24 h sustained aortic injury. Traumatic vascular injuries are rare in civilian settings and are less than 2% of major trauma admissions. These patients are often seriously injured and their treatment can be challenging with high 30-day mortality. Retrospectively registered.
Sections du résumé
BACKGROUND
BACKGROUND
Outcomes after vascular injuries in wartime are well documented, but studies on vascular injuries in a civilian European populations are scarce.
METHODS
METHODS
A retrospective study on all adults admitted to a North-European level 1-trauma centre 2009-2018 with The Abbreviated Injury Scale-codes for non-iatrogenic vascular trauma (VT). Data were extracted from both national and regional trauma-registries, as well as patient charts. Patient demographics, mechanism, and location of vascular injury were registered as well as its treatment. Incidence and injury scores (ISS, NISS and TRISS) were calculated and overall survival (Kaplan-Meier) estimated.
RESULTS
RESULTS
Of 4042 trauma-patients, 68 (1.7%) (median age 44 years, 76% males) sustained 81 vascular injuries (69 arterial; 12 venous); 46 blunt and 22 (32%) penetrating injuries. The total incidence of vascular injuries was 1.45/100,000 inhabitants and did not change over the study-period (95% confidence interval 1.13-1.82). The injuries were located in thorax (n = 17), neck (n = 16) and abdominal region (n = 15); most of the blunt injuries followed traffic (n = 31) or falling accidents (n = 10), and with 17 of the 22 penetrating injuries due to stabbing. The median ISS and NISS-scores were 22 and 33, with 50 (74%) and 55 (81%) patients having scores > 15, respectively. Forty-three (63%) patients had open surgical repair and 8 (12%) received endovascular treatment. Twenty-one patients died within 30-days (31%), 33% and 27% after blunt and penetrating injuries, respectively. Half of the patients that died within 24 h sustained aortic injury.
CONCLUSIONS
CONCLUSIONS
Traumatic vascular injuries are rare in civilian settings and are less than 2% of major trauma admissions. These patients are often seriously injured and their treatment can be challenging with high 30-day mortality.
TRIAL REGISTRATION
BACKGROUND
Retrospectively registered.
Identifiants
pubmed: 36544205
doi: 10.1186/s13049-022-01059-5
pii: 10.1186/s13049-022-01059-5
pmc: PMC9773450
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
74Informations de copyright
© 2022. The Author(s).
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