Role of endovascular management on outcomes in patients with traumatic inferior vena cava injuries.

Autor: O'Connor D; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA. Electronic address: DevinOConnor17@arizona.edu., Hejazi O; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA., Colosimo C; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA., Stewart C; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA., Hosseinpour H; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA., Khurshid M; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA., Nelson AC; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA., Joseph B; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA., Bhogadi SK; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA., Anand T; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA., Spencer AL; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA., Magnotti LJ; Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, University of Arizona Medical Center, Tucson, USA.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Dec; Vol. 238, pp. 115836. Date of Electronic Publication: 2024 Jul 11.
DOI: 10.1016/j.amjsurg.2024.115836
Abstrakt: Introduction: The aim of this study was to examine the association between the injury mechanism and repair type with outcomes in patients with traumatic inferior vena cava injuries.
Methods: This is a retrospective analysis of the ACS-TQIP database (2017-2020), including patients with traumatic IVC injuries. Patients were stratified by injury mechanism and type of repair and compared.
Results: Out of 1334 patients, 5 ​% underwent endovascular repair while 95 ​% had an open procedure. Overall, 74.7 ​% sustained a penetrating injury. On multivariable regression analysis, the type of repair was not associated with mortality and morbidity for patients with penetrating injuries. However, among patients with blunt injuries, endovascular repair was associated with lower odds of in-hospital mortality (aOR:0.35, p ​= ​0.020) and non-venous thromboembolism (VTE) morbidity (aOR:0.41, p ​= ​0.015), and higher odds of VTE complications (aOR:6.74, p ​< ​0.001).
Conclusions: Although the type of repair did not impact morbidity and mortality in patients with penetrating injuries, endovascular repair was identified as the only modifiable predictor of reduced non-VTE morbidity and mortality in patients with blunt injuries.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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