Citation

Davies E, Davenport R, Brohi K, Tai N, Walsh M. Inj. Extra 2008; 39(5): 160-160.

Affiliation

The Royal London Hospital, UK.

Copyright

(Copyright © 2008, Elsevier Publishing)

DOI

10.1016/j.injury.2007.11.301

PMID

unavailable

Abstract

Introduction: Vascular injuries are complex, challenging, time-critical and have a high mortality. We undertook this study to identify the incidence, mechanism and vessels involved in fatal vascular injuries at a UK urban trauma centre. Method: Retrospective review of all patients with vascular injuries over a 47-month period from July 2003 to May 2007. Results: A total of 3164 patients were admitted following a trauma call over the study period, 104 of which sustained vascular injuries (3.3%). The median (i.q. range) ISS for those with vascular injuries was 20 (10-34) whereas for all trauma patients it was 9 (1-16). Penetrating trauma comprised 46% vascular injuries (n = 48) of which 5 were gunshot wounds. Motor vehicle collisions were the cause for 40 of the 56 blunt vascular injuries. Among the patients with vascular injuries there were 20 deaths (19%), 7 penetrating trauma (all stab wounds) and 13 blunt trauma (7 motor vehicle collisions, 2 falls from height, 2 crushed by heavy objects, 1 blast injury, 1 hit by train). Conclusion: Vascular injuries are uncommon but carry a significant mortality. Death is usually associated with torso haemorrhage including junctional zones. The non-compressible nature of these injuries means that extremely rapid transportation and intervention are essential if mortality is to be reduced.