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Abdominal vascular trauma in 760 severely injured patients

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

The relevance of abdominal vascular injuries in polytraumatic patients within a large collective has not yet been thoroughly analyzed. This study aimed at assessing the prevalence of traumatic injuries in relation to outcome and currently established treatment options.

Methods

51,425 patients from the Trauma Registry of the German Society of Trauma Surgery (TR DGU) (1993–2009) were analyzed retrospectively. All patients who had an Injury Severity Score (ISS) of ≥16, were directly admitted to a trauma center and subsequently received treatment for at least three days, were ≥16 years old, and had an abdominal injury (AISabdomen ≥2) were included. Patients with abdominal trauma (AISabdomen ≥2) were compared with patients with additional vascular trauma (AISvascular 2–5).

Results

10,530 (20.5 %) of the 51,425 patients had documented abdominal injury. 760 (7.2 %) of the patients with abdominal injury additionally showed abdominal vascular injury (AISabdomen ≥2, AISvascular 2–5) and were analyzed based on the classification of the American Association for the Surgery of Trauma (AAST) organ severity score (AAST vascular injury grade: II, 2.4 %; III, 2.7 %; IV, 1.8 %; V, 0.2 %. Patients with high-grade abdominal vascular injury (grades IV and V) showed a significant increase in mortality (IV, 44.6 %; V, 60 %) and consequently a decrease in the need for surgical intervention (IV, 67.4 %; V, 64 %).

Conclusions

The results presented here show the prevalence and outcome of abdominal vascular injuries in a large collective within the TR DGU for the first time. Based on the current literature and these findings, a treatment algorithm has been developed.

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Acknowledgments

Finally, we would like to thank the members of the Polytrauma Study Group of the German Society of Trauma Surgery (DGU) for their many years of intensive work on the Trauma Registry. The Polytrauma Study Group was integrated into the Emergency, Intensive Care and Severe Injuries Department of the DGU at the start of 2008. The clinics that provided data to the Trauma Registry for this analysis are noted at http://www.traumaregister.de. We wish to expressly thank them for their cooperation.

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Authors and Affiliations

  1. Department of General, Visceral and Transplantation Surgery, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, NRW, Germany

    M. Heuer, G. M. Kaiser & A. Paul

  2. Department of Trauma Surgery, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, NRW, Germany

    B. Hussmann & S. Lendemans

  3. Faculty of Medicine, Institute for Research in Operative Medicine, University of Witten/Herdecke, Campus Cologne-Merheim, Ostmerheimer Str. 200, 51109, Cologne, NRW, Germany

    R. Lefering

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  1. M. Heuer
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  2. B. Hussmann
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  3. G. M. Kaiser
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  4. R. Lefering
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  5. A. Paul
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  6. S. Lendemans
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The Trauma Registry of the DGU

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Correspondence to M. Heuer.

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Heuer, M., Hussmann, B., Kaiser, G.M. et al. Abdominal vascular trauma in 760 severely injured patients. Eur J Trauma Emerg Surg 39, 47–55 (2013). https://doi.org/10.1007/s00068-012-0234-6

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  • DOI: https://doi.org/10.1007/s00068-012-0234-6

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