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Abstract
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OBJECTIVES: This population-based study aims to examine the demographics, mechanisms and outcomes of patients in Scotland suffering peripheral and non-aortocaval vascular trauma between 2011 and 2018.
METHODS: A retrospective observational study was conducted using prospectively collected data derived from the Scottish Trauma Audit Group (STAG) from 1(st) Jan 2011 to 31(st) Dec 2018. Peripheral and non-aortocaval vascular trauma patients were identified using Abbreviated Injury Severity (AIS) codes. Demographics, mechanisms, types of injury, severity and outcomes were analysed.
RESULTS: Of 30831 patients admitted with trauma to Scottish hospitals, 569 (1.8%) patients suffered a vascular injury during the 8-year study period with 275 (0.9%) patients sustaining a peripheral or non-aortocaval vascular injury. There were 221 (80%) men and 54 (20%) women with a median (range) age of 39 (14-88) years. Blunt trauma was responsible for 179 (65%) injuries, of which road traffic accidents were the most common mechanism. A further 67 (24%) injuries were due to penetrating trauma, of which assault was the most common cause. The most common injury was to abdominal arteries, [e.g., hepatic, renal, splenic]' (n=83) with an associated mortality rate of 17%. The median (range) Injury Severity Score (ISS) was 16 (4-75). Sixteen (6%) patients died in the Emergency Department (ED). Two hundred and twenty seven (83%) patients were taken to theatre during their admission with a 30-day perioperative mortality rate of 10%, compared to an overall mortality rate of 16%. Injuries to abdominal vein [e.g., portal, renal, splenic, superior mesenteric] had the highest number of associated deaths, with 11 (32%) out of 34 cases resulting in a fatality.
CONCLUSION: There is a low incidence of vascular trauma in Scotland. Blunt-force was responsible for more vascular injuries than penetrating trauma. Patients with peripheral and non-aortocaval vascular injuries are likely to be severely injured and suffer a high mortality rate.
Language: en |