| Abstrakt: |
Introduction:Femoral artery injury (FAI) after trauma is one of the most common vascular injuries evaluated in Trauma Centers. Data at the national level are lacking.Methods:We used Nationwide Inpatient Sample (NIS) data for 2016-2019 in our cross-sectional study. First, we extracted all cases older than 18-years that include the diagnosis of FAI. Then, we kept only the observations with a primary diagnostic category suggestive of trauma or cases that have a concurrent presence of trauma-related diagnoses. Baseline characteristics were evaluated as well as predictors of inpatient mortality. Exclusion criteria included transferred out cases and elective admissions. Appropriate survey and domain analyses were applied to obtain and study national estimates using SAS 9.4.Results:We identified 3,850 weighted admissions that contain a diagnosis of traumatic FAI. The mean age of surviving patients was 37-years (84% were male) in comparison to the mean age of 45-years (80% were male) for non-survival (p<0.0001). African American patients represented the majority (40%), followed by Caucasians (36%). Most patients were of low socioeconomic status (47%) and receiving Medicaid (37%). In-patient mortality was high, 9.5%, and more than 75% of death was within a week of admission. Although documentation of associated femoral vein, nerve, or femur injuries was not statistically significant, age >40-years, presence of comorbidities (especially cirrhosis), and intubation (indicating critical illness with acute respiratory failure or low Glasco-coma scale) were associated with inpatient mortality (p<0.0001). Lower extremity amputation (BKA/ AKA) was associated with higher mortality (not statistically significant). Neither open nor percutaneous femoral artery procedures (individually or combined) were associated with favored outcomes. On the other hand, thigh procedures on musculoskeletal tissues (muscles, fascia, femur) were associated with higher survival. The Area Under the Curve (AUC) of our model was 0.84.Conclusions:Our study suggests that young African American males are more likely to have traumatic FAI. Independent mortality predictors are age, Elixhauser comorbidities, and femur, muscular, soft tissues, and fascia procedures. |
