Document Detail

Limb outcome and mortality in lower and upper extremity arterial injury: a comparison using the National Trauma Data Bank.
MedLine Citation:
PMID:  21984027     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine the outcomes of lower extremity (LE) and upper extremity (UE) arterial trauma.
METHODS: Retrospective review of 2008 version of National Trauma Databank. Adult patient with LE and UE arterial trauma was identified and outcomes were compared.
RESULTS: There were 8311 cases of extremity arterial trauma and 37% involved the LE. The LE cohort had higher blunt injury (56.2% vs 37.4%; P < .0001). The LE cohort was more likely to require fasciotomy (23.6% vs 6.7%; P < .0001) and amputation (7.8% vs 1.3%; P < .0001). Complication (18.8% vs 5.1%; P < .0001) and mortality rate (7.7% vs 2.2%, P < .0001) were higher in the LE cohort. Regardless of extremity, blunt trauma was associated with higher mortality (4.8% vs 3.8%; P = .03) and amputation (6.7% vs 1.3%; P < .0001). In multivariable analysis, LE arterial trauma was associated with increased mortality (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.7-2.9; P < .0001) and amputation (OR 4.3, 95% CI 3.2-5.8; P < .0001).
CONCLUSIONS: Lower and upper extremity arterial injuries have different modes of presentation and outcomes. Lower extremity arterial trauma is more commonly caused by blunt injury and associated with worse outcomes despite more intensive intervention.
Tze-Woei Tan; Fernando L Joglar; Naomi M Hamburg; Robert T Eberhardt; Palma M Shaw; Denis Rybin; Gheorghe Doros; Alik Farber
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Vascular and endovascular surgery     Volume:  45     ISSN:  1938-9116     ISO Abbreviation:  Vasc Endovascular Surg     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-10     Completed Date:  2012-02-07     Revised Date:  2014-06-16    
Medline Journal Info:
Nlm Unique ID:  101136421     Medline TA:  Vasc Endovascular Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  592-7     Citation Subset:  IM    
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MeSH Terms
Amputation / mortality
Arteries / injuries,  surgery
Chi-Square Distribution
Databases as Topic
Fascia / surgery
Intensive Care Units
Length of Stay
Limb Salvage / mortality
Logistic Models
Lower Extremity / blood supply*
Middle Aged
Odds Ratio
Retrospective Studies
Risk Assessment
Risk Factors
Treatment Outcome
United States / epidemiology
Upper Extremity / blood supply*
Vascular Surgical Procedures / adverse effects,  mortality*
Vascular System Injuries / mortality*,  surgery*
Wounds, Nonpenetrating / mortality*,  surgery*
Young Adult
Grant Support

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

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