Vascular trauma in Western Australia: a comparison of two study periods over 15 years

Abstract

Background: Royal Perth Hospital (RPH) has become Western Australia's only designated adult major trauma facility since a previous study of vascular trauma was conducted in 2001 at the same facility. The aim of this study is to identify changes in vascular trauma patterns over the two study periods and compare these changes with international literature. Methods: All individuals presenting to RPH between January 2000 and December 2010 with vascular injury were identified from a prospective trauma database for this descriptive study. Injuries were classified using the Abbreviated Injury Score (AIS). Results: The incidence of vascular trauma as a percentage of total trauma increased over the two study periods. The current 10-year study included 45 164 patients on the trauma database, of which 1205 patients (2.6%) sustained 1335 vascular injuries, an increase from 1% in the previous 5-year study at the same facility. Males aged 20-29 years were more frequently injured. Blunt trauma occurred more frequently than penetrating. The extremities, particularly the upper limbs were most commonly injured. The most common causes of injury for each region were as follows; motorbike crash (MBC), motor vehicle crash (MVC) and stabbing (neck, thorax and abdomen), MBC and MVC (lower limb) and piercing injuries (upper limb). Injury Severity Score (ISS) and mortality 43% (32 of 75) were highest for thoracic injuries, particularly thoracic aorta injury. Mortality rate has decreased. Conclusion: Vascular injuries in Western Australia are increasing. MVC are the most common cause of life threatening injury. Road safety interventions targeting young males are likely to reduce trauma.

Peripheral Arterial Injuries: an Indian Experience

“…Blunt trauma accounted for majority of these cases in this study which is similar to an Australian study [6]. The percentage of blunt trauma is very high-46 of 49 trauma (93.8 %) cases-in this series compared to any study, probably due to lower incidence of gunshot and stab injuries.…”

“…All the reported series in literature are institutional and none of these are single-surgeon experience; this is to date is the first largest, single-surgeon experience series. Young men in productive age group (mean age 28 years) account for large number of patients as in the case of any trauma, which correlates with other studies [3,5,6]. Many of these patients are breadwinners of the family, and outcomes of arterial injury can have a major impact on the economy in addition to the health care burden.…”

“…Open arterial repair remains the golden standard of care but there is growing interest in endovascular options in select areas. The most common procedure was interposition graft which is similar to other studies [6,19]. Many cases had segmental loss necessitating interposition graft for tension-free repair.…”

Experiencia del Hospital de Especialidades del Centro Médico Nacional La Raza en pacientes con trauma vascular atendidos inicialmente en otra unidad

“…Del 60 al 90% de las lesiones civiles en el tronco o las extremidades son secundarias a mecanismos penetrantes, generalmente por armas de fuego. Las lesiones por trauma cerrado son infrecuentes, por lo general en pacientes de mayor edad; al implicar mecanismos de mayor fuerza y velocidad, se asocian con lesiones intrabdominales, torácicas, de tejidos blandos u óseos [2][3][4][5] .…”

Trends and outcomes in the management of vascular trauma: institutional experience at a level 1 trauma center

“…1 The most recent Australian study at high volume centre found that vascular trauma accounted for 3.2% of all trauma admissions and was increasing over time. 2 Furthermore, the literature suggests that the mortality rate of vascular trauma lies between 18 and 26%. [3][4][5] Given that this is dramatically higher than the mortality for overall trauma reported in Australia it is clear that vascular trauma and its treatment are a crucial aspect of trauma management at any institution.…”