Related Experiment Videos
Factors affecting mortality rate with iliac vein injuries
R F Wilson1, R G Wiencek, M Balog
1Department of Surgery, Wayne State University, Detroit Receiving Hospital, MI 48201.
The Journal of Trauma
|March 1, 1990
Summary
Iliac vein injuries resulted in a high 51% mortality rate, significantly exceeding other studies. Factors like low trauma scores and initial low blood pressure were associated with increased deaths in these patients.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Emergency Medicine
Background:
- Iliac vein injuries are severe trauma with high mortality.
- Previous studies report lower mortality rates for iliac vein injuries.
Purpose of the Study:
- To analyze mortality rates and associated factors in patients with iliac vein injuries.
- To identify factors contributing to the high mortality observed in this patient cohort.
Main Methods:
- Retrospective review of 49 patients treated for iliac vein injuries over an 8-year period.
- Analysis of injury types, mortality rates, and clinical factors including Trauma Score, Injury Severity Score (ISS), initial blood pressure, blood transfusion volume, and resuscitation status.
- Comparison of observed mortality with predicted survival using TRISS methodology.
Main Results:
- Overall mortality rate was 51% (25/49), significantly higher than reported in other series (18-38%).
- Specific mortality rates varied by injury location: common iliac vein (40%), internal iliac vein (65%), external iliac vein (29%), and multiple iliac veins (100%).
- Factors associated with increased mortality included Trauma Score < 11 (71%), initial systolic BP < 70 mm Hg (89%), ISS > 28 (65%), >10 units of blood transfused in 24 hours (65%), and unobtainable BP on admission (65%).
Conclusions:
- Iliac vein injuries present a high mortality risk, with specific injury patterns and patient factors significantly increasing this risk.
- Inadequate resuscitation, including failure to restore core temperature and repeated hypotensive episodes, may have contributed to preventable deaths.
- Improved resuscitation strategies, such as pelvic packing and timely closure, could potentially improve survival rates in these critically injured patients.