Abdominal and pelvic vascular trauma in Queensland, Australia: institutional experience at a level one trauma centre

Abstract

Background: Abdominal and pelvic vascular injuries are amongst the most lethal injuries sustained by trauma patients. Unlike internationally, the epidemiology is not well documented in Australia. Gold Coast University Hospital (GCUH) is a level one trauma centre in Queensland, Australia. This study aims to identify the epidemiological patterns of abdominal and pelvic vascular traumatic injuries, their interventions and outcomes, and compare these with national and international data. Methods: All individuals who presented to GCUH between January 2014 and December 2019 with abdominal or pelvic vascular injuries were retrieved from the GCUH prospective trauma database. A descriptive analysis was undertaken on this cohort. Results: The study reviewed 5452 trauma admissions to GCUH, of which 68 patients sustained abdominal or pelvic vascular injuries. The number of blunt and penetrating trauma cases were 53 (77.9%) and 15 (22.1%) respectively, and 51 (75%) of the patients were male. Interventions were required in 57 patients (83.8%). Of these interventions, 28 were open (41.2%), 27 were endovascular (39.7%) and 2 required both open and endovascular interventions (2.9%). The most commonly injured vessels were the visceral arteries (51.9%) and iliac arteries (22.7%). The mortality rate was 8.8% which were all as a result of blunt trauma. Conclusions: Abdominal and pelvic vascular trauma causes significant injuries with a higher mortality than general trauma. Given the majority of cases occurred secondary to road accidents, motor vehicle safety interventions and prevention programmes are likely to have the greatest effect on reducing the abdominal and pelvic vascular injury rate in Australia.

Atendimento de urgência e emergência a clientes grávidas vítimas de trauma abdominal

“…Trauma é uma das principais causas de morbidade e mortalidade em todo o mundo e continua sendo um grande problema de saúde pública entre todos os países. Foi estimado pelo ano 2020, 8,1 milhões de pessoas morreriam anualmente como resultado de lesões, a região do abdome representa 25% (Bowles, et al, 2021) Pesquisas realizadas por Fraga, et al 2005, mostra que os índices de trauma não foram fatores preditivos de prognostico para a mãe ou feto, os autores sugerem incorporação de ferramentas para o desenvolvimento de sistemas que possa avaliar a estimativa de prognostico materno fetal.…”

General surgical unit experience of traumatic vascular injuries in an Australian regional hospital

“…Two mortalities were reported following the complications of severe vascular injuries from blunt trauma, evident by other studies in Australia. 14,15 Surgical education on vascular trauma management and trauma care courses will improve the care given by the general surgical teams in regional hospitals. It will help to reduce the errors in vascular trauma care and improve the outcomes following damage control surgeries for vascular injuries performed in the regional centres.…”