Document Detail


Analysis of 185 iliac vessel injuries: risk factors and predictors of outcome.
MedLine Citation:
PMID:  14609865     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: Iliac vascular injuries incur high mortality. DESIGN: Retrospective 100-month study (January 1, 1992, through April 30, 2000). PATIENTS: One hundred forty-eight patients with 185 iliac vessel injuries. OUTCOME MEASURES: Survival and mortality, analyzed by univariate and logistic regression. RESULTS: Admission mean +/- SD systolic blood pressure was 81 +/- 42 mm Hg, mean Revised Trauma Score was 6.0 +/- 2.8, and mean Injury Severity Score was 20.0 +/- 9.5. The mechanism of injury was penetrating in 140 patients (95%) and blunt in 8 (5%). The mean estimated blood loss was 6246 +/- 6174 mL. Of the 185 injured vessels, 71 (99%) of 72 iliac arteries were repaired, 101 (89%) of 113 iliac veins were ligated, and 12 (11%) of 113 iliac veins were repaired. Overall survival was 51% (76/148). Mortality was 82% (49/72) in patients with exsanguination. Survival by vessel: iliac artery, 57% (20/35); iliac vein, 55% (42/76); and iliac artery and vein, 38% (14/37). Significant predictors of outcome were thoracotomy in the emergency department, associated aortic injury, inferior vena cava injuries, iliac artery and vein injury, intraoperative arrhythmia, and intraoperative coagulopathy. On logistic regression, independent risk factors for survival were absence of thoracotomy in the emergency department, surgical management, and arrhythmia. Mortality by grade on the Organ Injury Scale of the American Association for the Surgery of Trauma (AAST-OIS) was as follows: grade III, 35% (33/95); grade IV, 71% (24/34); and grade V, 79% (15/19). CONCLUSIONS: Mortality remains high. Associated vessel injuries and intraoperative complications predict mortality. AAST-OIS grade for abdominal vascular injuries correlates well with mortality.
Authors:
Juan A Asensio; Patrizio Petrone; Gustavo Roldán; Eric Kuncir; Vincent L Rowe; Linda Chan; William Shoemaker; Thomas V Berne
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  138     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-11     Completed Date:  2004-01-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1187-93; discussion 1193-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Division of Trauma and Critical Care, Los Angeles County, and University of Southern California Medical Center, Los Angeles 90033, USA. asensio@hsc.usc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Female
Humans
Iliac Artery / injuries*,  surgery
Iliac Vein / injuries*,  surgery
Male
Predictive Value of Tests
Retrospective Studies
Risk Factors
Trauma Severity Indices
Treatment Outcome
Vascular Surgical Procedures / methods
Wounds and Injuries / epidemiology*,  mortality,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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