Document Detail

Does improved detection of blunt vertebral artery injuries lead to improved outcomes? Analysis of the National Trauma Data Bank.
MedLine Citation:
PMID:  18648873     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The rate of blunt vertebral artery (BVI) has increased in institutions using aggressive screening protocols. It is unclear whether earlier diagnosis and therapy have improved outcomes. Our goal was to estimate the national incidence of BVI and BVI-related stroke (BVI-S), and report on the functional outcome of patients with this diagnosis. METHODS: The annual rates of BVI and BVI-S were estimated by using the National Trauma Data Bank (NTDB) from 2001 to 2005. The functional outcome was evaluated by the modified functional independence measure (FIM) score (range, 3-12). RESULTS: A total of 574 patients with BVI were identified among the 761,385 blunt trauma admissions (0.075% overall incidence). BVI-S was diagnosed in 12% of patients with BVI and no associated blunt carotid injury. The FIM on discharge was 9.62 +/- 2.78 (range, 3-12), and 49% of the patients showed complete functional independence. Overall mortality was 8%. The annual incidence showed a steady increase from 0.053% in 2001 to 0.1% in 2005 (p < 0.001). No difference in annual BVI-S and complete functional independence was observed. CONCLUSIONS: As a result of increased awareness, the nation-wide rate of detection of BVI has doubled in recent years. However, BVI-S rates and functional outcome have not improved, raising questions about the available treatment protocols.
Konstantinos Spaniolas; George C Velmahos; Hasan B Alam; Marc de Moya; Malek Tabbara; Elizabeth Sailhamer
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  32     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-11     Completed Date:  2009-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2190-4     Citation Subset:  IM    
Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Boston, MA 02114, USA.
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MeSH Terms
Hospital Mortality
Treatment Outcome
United States / epidemiology
Vertebral Artery / injuries*
Wounds, Nonpenetrating / diagnosis*,  epidemiology,  mortality

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