Outcomes of traumatic extremity vascular injuries from a Malaysian level 1 trauma center.

Autor: Lip HTC; Trauma Surgery Unit, Department of General Surgery, Hospital Sultanah Aminah, Jalan Abu Bakar, masjid abu bakar, Johor Bahru 81100, Malaysia. Electronic address: relos1402@gmail.com., Huei TJ; Trauma Surgery Unit, Department of General Surgery, Hospital Sultanah Aminah, Jalan Abu Bakar, masjid abu bakar, Johor Bahru 81100, Malaysia., Peng LE; Trauma Surgery Unit, Department of General Surgery, Hospital Sultanah Aminah, Jalan Abu Bakar, masjid abu bakar, Johor Bahru 81100, Malaysia., Huan KZ; Trauma Surgery Unit, Department of General Surgery, Hospital Sultanah Aminah, Jalan Abu Bakar, masjid abu bakar, Johor Bahru 81100, Malaysia., Sen CJ; Trauma Surgery Unit, Department of General Surgery, Hospital Sultanah Aminah, Jalan Abu Bakar, masjid abu bakar, Johor Bahru 81100, Malaysia., Muhamad I; Trauma Surgery Unit, Department of General Surgery, Hospital Sultanah Aminah, Jalan Abu Bakar, masjid abu bakar, Johor Bahru 81100, Malaysia., Mohamad Y; Trauma Surgery Unit, Department of General Surgery, Hospital Sultanah Aminah, Jalan Abu Bakar, masjid abu bakar, Johor Bahru 81100, Malaysia., Alwi RI; Trauma Surgery Unit, Department of General Surgery, Hospital Sultanah Aminah, Jalan Abu Bakar, masjid abu bakar, Johor Bahru 81100, Malaysia.
Jazyk: angličtina
Zdroj: Injury [Injury] 2022 Sep; Vol. 53 (9), pp. 3005-3010. Date of Electronic Publication: 2022 Mar 26.
DOI: 10.1016/j.injury.2022.03.056
Abstrakt: Background: In Malaysia, management of traumatic vascular injuries is at the discretion of the treating surgeon (trauma or vascular surgery). This study was conducted to report on the epidemiology, mechanism of injury and outcomes of vascular injuries managed in a regional level 1 trauma center.
Methods: This is a retrospective cohort study of all patients treated for traumatic extremity vascular injuries from January 2018 to December 2020. Demography, mechanism of injury, pre-operative physiologic vital signs, vessel injured, injury severity (NISS, RTS and TRISS score), type of revascularization surgery, fasciotomy, post-operative blood investigations, operative outcomes (amputation, length of stay and ICU admission) and long-term rehabilitation follow-up were recorded and analyzed.
Results: Amongst the 35 recorded vascular injuries only 28 patients had adequate data that were included in the analysis. Majority of patients were males (23/28patients; 82%). Blunt injury to vessels was more likely in motorcycle crashes (16/28patients; 76%) than in automobile crashes (5/28patients; 24%). There were three lower limb amputees (3/3patients; 100%) that had early fasciotomy and were associated with three-fold higher post-operative median (interquartile range) CK levels of 16740 (8157 to 23116) u/l. Only two thirds (16/28 patients) had active rehabilitation follow-up and were back to work after a median duration of four months.
Conclusion: Male gender, blunt injury, road traffic crashes and motorcycles were the majority of vascular injuries. Lower limb vascular injuries had poorer outcome with three amputations performed after attempts at revascularization. Fasciotomy and high CK level may be related to higher risk of limb loss. Our study highlights the importance of rehabilitation and long-term follow-up in this cohort of patients.
Competing Interests: Declaration of Competing Interest All authors declare no competing interests in this study. This is a self-funded study.
(Copyright © 2022. Published by Elsevier Ltd.)
Databáze: MEDLINE
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