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Contemporary management and prognosis of great vessels trauma

Szu-An Chen1, Jen-Fu Huang1, Yu-San Tee1

  • 1Department of Traumatology and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.

Injury
|April 10, 2019
PubMed

Insights

Great vessel trauma (GVT) is a rare but lethal injury. Survival depends on injury severity and shock status, with vena caval injuries being a key predictor of mortality.

Area of Science:

  • Trauma Surgery
  • Vascular Surgery
  • Emergency Medicine

Background:

  • Great vessel trauma (GVT), involving the aorta or vena cava, presents significant management challenges and high mortality rates.
  • Optimal treatment strategies for GVT remain debated within the medical community.

Purpose of the Study:

  • To review the incidence, management, and outcomes of GVT.
  • To identify prognostic factors and compare treatment results for GVT patients.

Main Methods:

  • Retrospective, single-center cohort study of GVT patients from August 2008 to December 2013.
  • Data collected included demographics, injury details, treatment choices, hospital stay, and mortality.
  • Analysis focused on risks of adverse outcomes and mortality.

Main Results:

  • A cohort of 74 patients experienced a 27% mortality rate.
  • Prognostic factors for survival included male gender, lower Injury Severity Score (ISS), higher Glasgow Coma Scale (GCS), and higher blood pressure.
  • Vena caval injuries were identified as the primary predictor of mortality.

Conclusions:

  • GVT is infrequent but carries a high fatality rate.
  • Patient survival is linked to injury severity and shock grade.
  • Aggressive resuscitation, coordinated surgical expertise, and innovative treatments are crucial for improving outcomes, especially for vena caval injuries.
Abstract

Keywords:
Aortic traumaGreat vessel injuryTraumaVena caval trauma

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