Abstract
Hypothesis: Iliac vascular injuries incur high mortality. Design: Retrospective 100-month study Oanuary 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.
| Original language | English |
|---|---|
| Pages (from-to) | 1187-1194 |
| Number of pages | 8 |
| Journal | Archives of Surgery |
| Volume | 138 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 2003 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Surgery
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Analysis of 185 Iliac Vessel Injuries : Risk Factors and Predictors of Outcome. / Asensio, Juan A.; Petrone, Patrizio; Roldán, Gustavo; Kuncir, Eric; Rowe, Vincent L.; Chan, Linda; Shoemaker, William; Berne, Thomas V.; Messina, Louis M.; MacKersie, Robert C.; Shatney, Clayton H.; Wisner, David; Goldstein, Lawrence J.; Peck, James J.
In: Archives of Surgery, Vol. 138, No. 11, 11.2003, p. 1187-1194.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Analysis of 185 Iliac Vessel Injuries
T2 - Risk Factors and Predictors of Outcome
AU - Asensio, Juan A.
AU - Petrone, Patrizio
AU - Roldán, Gustavo
AU - Kuncir, Eric
AU - Rowe, Vincent L.
AU - Chan, Linda
AU - Shoemaker, William
AU - Berne, Thomas V.
AU - Messina, Louis M.
AU - MacKersie, Robert C.
AU - Shatney, Clayton H.
AU - Wisner, David
AU - Goldstein, Lawrence J.
AU - Peck, James J.
PY - 2003/11
Y1 - 2003/11
N2 - Hypothesis: Iliac vascular injuries incur high mortality. Design: Retrospective 100-month study Oanuary 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.
AB - Hypothesis: Iliac vascular injuries incur high mortality. Design: Retrospective 100-month study Oanuary 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.
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U2 - 10.1001/archsurg.138.11.1187
DO - 10.1001/archsurg.138.11.1187
M3 - Article
VL - 138
SP - 1187
EP - 1194
JO - JAMA Surgery
JF - JAMA Surgery
SN - 2168-6254
IS - 11
ER -