Brachial Plexus Injury Significantly Increases Risk of Axillosubclavian Vessel Injury in Blunt Trauma Patients With Clavicle Fractures
| Autor: | Nii-Kabu Kabutey, John A. Scolaro, Sebastian D. Schubl, Jeffry Nahmias, Areg Grigorian, Erika Tay, Michael Lekawa, Christian de Virgilio |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Subclavian Artery 030230 surgery Subclavian Vein Wounds Nonpenetrating Risk Assessment Fractures Bone 03 medical and health sciences 0302 clinical medicine Peripheral Nerve Injuries Risk Factors 030202 anesthesiology Humans Medicine Brachial Plexus In patient Axillary Vein Aged Retrospective Studies Aged 80 and over business.industry Incidence General Medicine Middle Aged Vascular System Injuries medicine.disease Clavicle Surgery Logistic Models medicine.anatomical_structure Brachial plexus injury Blunt trauma Concomitant Multivariate Analysis Axillary Artery Female business Brachial plexus |
| Zdroj: | The American Surgeon. 87:747-752 |
| ISSN: | 1555-9823 0003-1348 |
| Popis: | Background A national analysis of clavicle fractures is lacking and the risk of concomitant axillosubclavian vessel injury (ASVI) in patients with clavicle fractures is unknown. A minority of patients may have a combined brachial plexus injury (BPI). We sought to describe risk factors for concomitant ASVI in patients with a clavicle fracture; hypothesizing patients with combined clavicle fracture and BPI has a higher risk of ASVI. Methods The Trauma Quality Improvement Program (2010-2016) was queried for blunt trauma patients with a clavicle fracture. A multivariable logistic regression model was used to determine risk factors for ASVI. A subset analysis on patients with isolated clavicle fractures was additionally performed. Results From 59 198 patients with clavicle fractures, 341 (.6%) had concomitant ASVI. Compared to patients without ASVI, patients with ASVI had a higher median injury severity score (24 vs. 17, P < .001) and rates of pulmonary contusions (43.4% vs. 37.7%, P = .029) and BPI (18.2% vs. .4%, P < .001). After controlling for associated chest wall injuries and humerus fracture, the BPI odds ratio (OR 49.17, 35.59-67.92, P < .001) was independently associated with risk for ASVI. In a subset analysis of isolated clavicle fractures, BPI remained associated with risk of ASVI (OR 60.01, confidence intervals 25.29-142.39, P < .001). Conclusion The rate of concomitant ASVI in patients with a clavicle fracture is |
| Databáze: | OpenAIRE |
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