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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 naortic 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 def-icit (< −10 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.
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Article info
Footnotes
**Presented at the 48th Annual Meeting of the Southwestern Surgical Congress, Scottsdale, Arizona, April 28–May 1, 1996.
Identification
Copyright
© 1996 Excerpta Medica, Inc. All rights reserved. Published by Elsevier Inc.
