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Risk Factors and Management of Blunt Inferior Vena Cava Injury: A Retrospective Study

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A Correction to this article was published on 25 July 2023

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Abstract

Background

Traumatic inferior vena cava (IVC) injuries are uncommon, but the mortality rate remains high at 38–70%. To date, most studies on traumatic IVC injuries have evaluated blunt rather than penetrating injuries. We aimed to identify the clinical features and risk factors that affect the prognosis of patients with blunt IVC injuries to improve treatment strategies for these patients.

Methods

We retrospectively analyzed patients diagnosed with blunt IVC injury over 8 years at a single trauma center. Clinical and biochemical parameters; transfusion, surgical, and resuscitation methods; associated injuries; intensive care unit stay; and complications data were compared between survival and death groups to identify clinical features and risk factors of blunt IVC injury-related mortality.

Results

Twenty-eight patients with blunt IVC injury were included during the study periods. Twenty-five (89%) patients underwent surgical treatment, and the mortality was 54%. The mortality rate according to the IVC injury location was the lowest for supra-hepatic IVC injury (25%, n = 2/8), whereas it was the highest for retrohepatic IVC injury (80%, n = 4/5). In the logistic regression analysis, Glasgow Coma Scale (GCS) (odds ratio [OR] = 0.566, 95% confidence interval [CI] [0.322–0.993], p = 0.047) and red blood cell (RBC) transfusion for 24 h (OR = 1.132, 95% CI [0.996–1.287], p = 0.058) were independent predictors for mortality.

Conclusions

Low GCS score and high-volume packed RBC transfusion requirements for 24 h were significant predictors of mortality in patients with blunt IVC injuries. Unlike IVC injuries caused by penetrating trauma, supra-hepatic IVC injuries caused by blunt trauma have a good prognosis.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea

    Donghwan Choi, Byung Hee Kang, Kyoungwon Jung & Jonghwan Moon

  2. Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Republic of Korea

    Sang-Hyun Lim

Author notes

  1. The original online version of this article was revised: Figures 2 and 3 were corrected.

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    1. Donghwan Choi
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    Contributions

    Conception and design: JM, DC, KJ, BK, SL. Analysis and interpretation: JM, DC, KJ, BK. Data collection: JM, DC, SL. Writing the article: JM, DC. Critical revision of the article: JM, DC, KJ, BK, SL. Final approval of the article: JM, DC, KJ, BK, SL. Statistical analysis: JM, DC, BK. Obtained funding: Non applicable. Overall responsibility: JM.

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    Correspondence to Jonghwan Moon.

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    The study was approved by the Institutional Review Board of our institution (AJIRB-MED-MDB-2022–229).

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    The requirement for informed consent was waived by the review board owing to the retrospective nature of the study.

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    Choi, D., Kang, B.H., Jung, K. et al. Risk Factors and Management of Blunt Inferior Vena Cava Injury: A Retrospective Study. World J Surg 47, 2347–2355 (2023). https://doi.org/10.1007/s00268-023-07110-5

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