TY  - JOUR
T1  - Analysis of 185 iliac vessel injuries: Risk factors and predictors of outcome
AU  - Asensio JA, Petrone P, Roldán G, et al
Y1  - 2003/11/01
N1  - 10.1001/archsurg.138.11.1187
JO  - Archives of Surgery
SP  - 1187
EP  - 1194
VL  - 138
IS  - 11
N2  - Hypothesis 
    Iliac vascular injuries incur high mortality.Design 
    Retrospective 100-month study (January 1, 1992, through April 30, 2000).Patients 
    One hundred forty-eight patients with 185 iliac vessel injuries.Outcome Measures 
    Survival and mortality, analyzed by univariate and logistic regression.Results 
    Admission mean ± SD systolic blood pressure was 81 ± 42 mm Hg, mean Revised Trauma Score was 6.0 ± 2.8, and mean Injury Severity Score was 20.0 ± 9.5. The mechanism of injury was penetrating in 140 patients (95%) and blunt in 8 (5%). The mean estimated blood loss was 6246 ± 6174 mL. Of the 185 injured vessels, 71 (99%) of 72 iliac arteries were repaired, 101 (89%) of 113 iliac veins were ligated, and 12 (11%) of 113 iliac veins were repaired. Overall survival was 51% (76/148). Mortality was 82% (49/72) in patients with exsanguination. Survival by vessel: iliac artery, 57% (20/35); iliac vein, 55% (42/76); and iliac artery and vein, 38% (14/37). Significant predictors of outcome were thoracotomy in the emergency department, associated aortic injury, inferior vena cava injuries, iliac artery and vein injury, intraoperative arrhythmia, and intraoperative coagulopathy. On logistic regression, independent risk factors for survival were absence of thoracotomy in the emergency department, surgical management, and arrhythmia. Mortality by grade on the Organ Injury Scale of the American Association for the Surgery of Trauma (AAST-OIS) was as follows: grade III, 35% (33/95); grade IV, 71% (24/34); and grade V, 79% (15/19).Conclusions 
    Mortality remains high. Associated vessel injuries and intraoperative complications predict mortality. AAST-OIS grade for abdominal vascular injuries correlates well with mortality.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.138.11.1187
UR  - http://dx.doi.org/10.1001/archsurg.138.11.1187
ER  -