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Predictors of Mortality for Upper Extremity Penetrating Vascular Injuries.
Justine S Broecker1, A Hsu2, M Kochuba2
1Department of Surgery, Mayo Clinic Florida, Jacksonville, FL.
Annals of Vascular Surgery
|December 28, 2024
Summary
Operative repair significantly reduces mortality for patients with upper extremity penetrating vascular injuries (UEPVIs). Injury severity and age predict longer hospital stays in those undergoing surgery.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Emergency Medicine
Background:
- Upper extremity penetrating vascular injuries (UEPVIs) present unique challenges in trauma care.
- Understanding risk factors and outcomes is crucial for optimizing patient management.
Purpose of the Study:
- To identify risk factors associated with UEPVIs.
- To evaluate operative outcomes, including mortality and length of stay, for patients with UEPVIs.
Main Methods:
- Retrospective review of adult UEPVI patients at a level I trauma center (1986-2019).
- Statistical analysis to determine predictors of mortality and hospital length of stay (LOS) post-operative repair.
Main Results:
- The majority of UEPVI patients were male, Caucasian, and uninsured/underinsured, with injuries often resulting from violence.
- Female patients had higher injury severity but lower mortality compared to males.
- Operative repair was associated with a significantly lower odds ratio of mortality (0.20).
- Injury Severity Score (ISS) was a significant predictor of longer LOS among operative patients.
Conclusions:
- UEPVIs predominantly affect men and are frequently linked to violent incidents.
- Surgical intervention demonstrates a protective effect against mortality in UEPVI patients.
- Advanced age and higher ISS are associated with prolonged hospital stays following operative repair.
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