Abstract
Background: Femoral vessel injuries are the most common vascular injuries treated in a Level I trauma center. No studies have identified risk factors for survival and complications. Study design: We performed a retrospective, 132-month study that included univariate and multivariate analyses. Results: We studied 204 patients with 298 vessel injuries: 204 were arterial, 94 were venous. Mean age (± SD) was 29 ± 13 years and mean Injury Severity Score (± SD) was 17 ± 8. There were 176 (86%) penetrating injuries and 28 (14%) blunt injuries. Arterial repairs included: reverse saphenous vein graft bypass, 108 (53%); primary repair, 53 (26%); PTFE, 21 (10.2%); ligation, 13 (6.4%); and vein patch, 9 (4.4%). Venous repairs included: ligation, 49 (52%); primary repair, 41 (44%); and bypass, 4 (4%). Fasciotomies included: calf, 56 (27%); thigh, 25 (12%); traumatic amputations, 6 (3%); and delayed amputations, 0. Overall survival rate was 91% (186 of 204), and adjusted survival was 95% (excluding emergency department thoracotomy deaths). There were 1 or more complications in 47 (23%), including wound infection, 31 (15%); venous thrombosis, 6 (3%); bleeding, 5 (2.5%); ARDS, 4 (2%); and arterial thrombosis, 1 (0.5%). Predictors of mortality were age > 45 years, Injury Severity Score > 25, common femoral artery injury, associated venous and abdominal injury, hypotension, hypothermia, and acidosis; coagulopathy in the operating room and the need for PTFE repair also predicted outcomes. Predictors of postoperative complications were intraoperative hypotension, arterial intimal injury, bony fracture, and thoracic injury. Conclusions: Although survival and limb salvage rates are high for femoral vessel injuries, these injuries incur high complication rates. Independent predictors for mortality are: Injury Severity Score > 25, Glasgow Coma Scale 28, presence of coagulopathy in the operating room, presence of two or more vascular signs, and age > 45 years.
| Original language | English |
|---|---|
| Pages (from-to) | 512-520 |
| Number of pages | 9 |
| Journal | Journal of the American College of Surgeons |
| Volume | 203 |
| Issue number | 4 |
| DOIs | |
| State | Published - Oct 2006 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Surgery
Cite this
Femoral Vessel Injuries : Analysis of Factors Predictive of Outcomes. / Asensio, Juan A.; Kuncir, Eric J.; García-Núñez, Luis M.; Petrone, Patrizio.
In: Journal of the American College of Surgeons, Vol. 203, No. 4, 10.2006, p. 512-520.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Femoral Vessel Injuries
T2 - Analysis of Factors Predictive of Outcomes
AU - Asensio, Juan A.
AU - Kuncir, Eric J.
AU - García-Núñez, Luis M.
AU - Petrone, Patrizio
PY - 2006/10
Y1 - 2006/10
N2 - Background: Femoral vessel injuries are the most common vascular injuries treated in a Level I trauma center. No studies have identified risk factors for survival and complications. Study design: We performed a retrospective, 132-month study that included univariate and multivariate analyses. Results: We studied 204 patients with 298 vessel injuries: 204 were arterial, 94 were venous. Mean age (± SD) was 29 ± 13 years and mean Injury Severity Score (± SD) was 17 ± 8. There were 176 (86%) penetrating injuries and 28 (14%) blunt injuries. Arterial repairs included: reverse saphenous vein graft bypass, 108 (53%); primary repair, 53 (26%); PTFE, 21 (10.2%); ligation, 13 (6.4%); and vein patch, 9 (4.4%). Venous repairs included: ligation, 49 (52%); primary repair, 41 (44%); and bypass, 4 (4%). Fasciotomies included: calf, 56 (27%); thigh, 25 (12%); traumatic amputations, 6 (3%); and delayed amputations, 0. Overall survival rate was 91% (186 of 204), and adjusted survival was 95% (excluding emergency department thoracotomy deaths). There were 1 or more complications in 47 (23%), including wound infection, 31 (15%); venous thrombosis, 6 (3%); bleeding, 5 (2.5%); ARDS, 4 (2%); and arterial thrombosis, 1 (0.5%). Predictors of mortality were age > 45 years, Injury Severity Score > 25, common femoral artery injury, associated venous and abdominal injury, hypotension, hypothermia, and acidosis; coagulopathy in the operating room and the need for PTFE repair also predicted outcomes. Predictors of postoperative complications were intraoperative hypotension, arterial intimal injury, bony fracture, and thoracic injury. Conclusions: Although survival and limb salvage rates are high for femoral vessel injuries, these injuries incur high complication rates. Independent predictors for mortality are: Injury Severity Score > 25, Glasgow Coma Scale 28, presence of coagulopathy in the operating room, presence of two or more vascular signs, and age > 45 years.
AB - Background: Femoral vessel injuries are the most common vascular injuries treated in a Level I trauma center. No studies have identified risk factors for survival and complications. Study design: We performed a retrospective, 132-month study that included univariate and multivariate analyses. Results: We studied 204 patients with 298 vessel injuries: 204 were arterial, 94 were venous. Mean age (± SD) was 29 ± 13 years and mean Injury Severity Score (± SD) was 17 ± 8. There were 176 (86%) penetrating injuries and 28 (14%) blunt injuries. Arterial repairs included: reverse saphenous vein graft bypass, 108 (53%); primary repair, 53 (26%); PTFE, 21 (10.2%); ligation, 13 (6.4%); and vein patch, 9 (4.4%). Venous repairs included: ligation, 49 (52%); primary repair, 41 (44%); and bypass, 4 (4%). Fasciotomies included: calf, 56 (27%); thigh, 25 (12%); traumatic amputations, 6 (3%); and delayed amputations, 0. Overall survival rate was 91% (186 of 204), and adjusted survival was 95% (excluding emergency department thoracotomy deaths). There were 1 or more complications in 47 (23%), including wound infection, 31 (15%); venous thrombosis, 6 (3%); bleeding, 5 (2.5%); ARDS, 4 (2%); and arterial thrombosis, 1 (0.5%). Predictors of mortality were age > 45 years, Injury Severity Score > 25, common femoral artery injury, associated venous and abdominal injury, hypotension, hypothermia, and acidosis; coagulopathy in the operating room and the need for PTFE repair also predicted outcomes. Predictors of postoperative complications were intraoperative hypotension, arterial intimal injury, bony fracture, and thoracic injury. Conclusions: Although survival and limb salvage rates are high for femoral vessel injuries, these injuries incur high complication rates. Independent predictors for mortality are: Injury Severity Score > 25, Glasgow Coma Scale 28, presence of coagulopathy in the operating room, presence of two or more vascular signs, and age > 45 years.
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U2 - 10.1016/j.jamcollsurg.2006.06.020
DO - 10.1016/j.jamcollsurg.2006.06.020
M3 - Article
VL - 203
SP - 512
EP - 520
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
SN - 1072-7515
IS - 4
ER -