The ongoing challenge of retroperitoneal vascular injuries. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Retroperitoneal vascular injury remains one of the most frequent causes of death following abdominal trauma. A risk analysis of the association between potential outcome predictors and mortality following abdominal aorta and inferior vena cava injuries was performed. METHODS: Eighty-nine patients sustaining abdominal aortic or inferior vena cava injury were concurrently evaluated for a 10-year period and retrospectively reviewed. A multiple logistic regression model evaluated the following variables:presence of shock on admission, base deficit (< -10 or > or = -10), classification by the organ injury scale (OIS), blood transfusion, crystalloid infusion, total infusion volume, associated injuries, site of injury, and presence of retroperitoneal tamponade. RESULTS: Overall mortality for all injuries was 57%. Excluding all death on arrival (DOA) patients, the mortality rate decreased to 45.7%. Death following abdominal aortic injuries was significantly associated with free bleeding in the peritoneal cavity, acidosis, and an injury in the suprarenal location (OIS > 4). For inferior vena cava injuries and combined abdominal aortic and inferior vena cava injuries, death was associated with free bleeding, the suprarenal location (OIS = 4), and the presence of shock on admission as well. CONCLUSIONS: Despite advances in transport and resuscitation, mortality of aortic and vena cava injuries remains unchanged. Shock on admission, bleeding without retroperitoneal tamponade, acidosis, and the suprarenal location each play a significant role in mortality. Immediate identification associated with a rapid surgical approach are the only factors that may improve survival of such devastating injuries.

publication date

  • November 1, 1996

Research

keywords

  • Aorta, Abdominal
  • Vena Cava, Inferior
  • Wounds, Nonpenetrating
  • Wounds, Penetrating

Identity

Scopus Document Identifier

  • 0030297482

Digital Object Identifier (DOI)

  • 10.1016/S0002-9610(96)00231-0

PubMed ID

  • 8942560

Additional Document Info

volume

  • 172

issue

  • 5