Epidemiology and Outcomes of Peripheral and Non-Aortocaval Vascular Trauma in Scotland 2011 – 2018

Published:December 01, 2022DOI:


      This population based study aimed to examine the demographics, mechanisms, and outcomes of patients in Scotland suffering peripheral and non-aortocaval vascular trauma between 2011 and 2018.


      A retrospective observational study was conducted using prospectively collected data derived from the Scottish Trauma Audit Group (STAG) from 1 January 2011 to 31 December 2018. Peripheral and non-aortocaval vascular trauma patients were identified using Abbreviated Injury Severity (AIS) codes. Demographics, mechanisms, types of injury, severity, and outcomes were analysed.


      Of 30 831 patients admitted with trauma to Scottish hospitals, 569 (1.8%) patients suffered a vascular injury during the eight year study period with 275 (0.9%) patients sustaining a peripheral or non-aortocaval vascular injury. There were 221 (80%) men and 54 (20%) women with a median (range) age of 39 (14 – 88) years. Blunt trauma was responsible for 179 (65%) injuries, of which road traffic accidents were the most common mechanism. A further 67 (24%) injuries were due to penetrating trauma, of which assault was the most common cause. The most common injury was to abdominal arteries (e.g., hepatic, renal, splenic [n = 83]) with an associated mortality rate of 17%. The median (range) Injury Severity Score (ISS) was 16 (4 – 75). Sixteen (6%) patients died in the Emergency Department (ED). Two hundred and twenty-seven (83%) patients were taken to theatre during their admission with a 30 day peri-operative mortality rate of 10%, compared with an overall mortality rate of 16%. Injuries to an abdominal vein (e.g., portal, renal, splenic, superior mesenteric) had the highest number of associated deaths, with 11 (32%) of 34 cases resulting in a fatality.


      There is a low incidence of vascular trauma in Scotland. Blunt force was responsible for more vascular injuries than penetrating trauma. Patients with peripheral and non-aortocaval vascular injuries are likely to be severely injured and suffer a high mortality rate.


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        • Nish L.
        • Rossi M.
        • Arnot J.
        • Mackie P.
        Scottish Public Health Network (ScotPHN) Preventing Major Trauma in Scotland: Supporting Population Interventions.
        2019 (Available at:)
      1. Scottish Trauma Network. Available at: [Accessed 20 July 2021].

        • Perkins Z.B.
        • De’Ath H.D.
        • Aylwin C.
        • Brohi K.
        • Walsh M.
        • Tai N.R.M.
        Epidemiology and outcome of vascular trauma at a British major trauma Centre.
        Eur J Vasc Endovasc Surg. 2012; 44: 203-209
        • Gupta R.
        • Rao S.
        • Sieunarine K.
        An epidemiological view of vascular trauma in western Australia: a 5-year study.
        ANZ J Surg. 2001; 71: 461-466
        • Norton J.
        • Whittaker G.
        • Kennedy D.S.
        • Jenkins J.M.
        • Bew D.
        Shooting up? Analysis of 182 gunshot injuries presenting to a London major trauma centre over a seven-year period.
        Ann R Coll Surg Engl. 2018; 100: 464-474
        • Tambyraja A.L.
        • Scollay J.M.
        • Beard D.
        • Henry J.M.
        • Murie J.A.
        • Chalmers R.T.A.
        Aortic trauma in Scotland – a population based study.
        Eur J Vasc Endovasc Surg. 2006; 32: 686-689
        • Brady R.R.W.
        • Bandari M.
        • Kerssens J.J.
        • Paterson-Brown S.
        • Parks R.W.
        Splenic trauma in Scotland: demographics and outcomes.
        World J Surg. 2007; 31: 2111-2116
        • Bariol S.V.
        • Stewart G.D.
        • Smith R.D.
        • McKeown D.W.
        • Tolley D.A.
        An analysis of urinary tract trauma in Scotland: impact on management and resource needs.
        Surgeon. 2005; 3: 27-30
        • Desai P.
        • Macewen C.J.
        • Baines P.
        • Minassian D.C.
        Epidemiology and implications of ocular trauma admitted to hospital in Scotland.
        J Epidemiol Community Health. 1996; 50: 436-441
        • Gennarelli T.A.
        • Wodzin E.
        AIS 2005: a contemporary injury scale.
        Injury. 2006; 37: 1083-1091
        • Copes W.S.
        • Champion H.R.
        • Sacco W.J.
        • Lawnick M.M.
        • Keast S.L.
        • Bain L.W.
        The injury severity score revisited.
        J Trauma. 1988; 28: 69-76
        • Scottish Trauma Audit Group (STAG)
        Scottish Trauma Audit Group (STAG): Inclusion/exclusion criteria (Internet).
        2020 (Available at:)
      2. Scottish Public Health Observatory. Injuries: road traffic injuries Available at: [Accessed 23 August 2021].

        • Scottish Government
        Recorded Crime in Scotland, 2019-20 (Internet).
        2020 (Available at)
        • Beitler A.L.
        • Wortmann G.W.
        • Hofmann L.J.
        • Goff J.M.J.
        Operation enduring freedom: the 48th Combat Support Hospital in Afghanistan.
        Mil Med. 2006; 171: 189-193
        • Creamer K.M.
        • Edwards M.J.
        • Shields C.H.
        • Thompson M.W.
        • Yu C.E.
        • Adelman W.
        Pediatric wartime admissions to US military combat support hospitals in Afghanistan and Iraq: learning from the first 2,000 admissions.
        J Trauma. 2009; 67: 762-768
        • Patel J.A.
        • White J.M.
        • White P.W.
        • Rich N.M.
        • Rasmussen T.E.
        A contemporary, 7-year analysis of vascular injury from the war in Afghanistan.
        J Vasc Surg. 2018; 68: 1872-1879
        • Weller J.
        • Bowles M.
        • Summers Z.
        • Bhamidipaty V.
        The epidemiology and outcomes of vascular trauma in Gold Coast, Australia: institutional experience at a level 1 trauma centre.
        ANZ J Surg. 2021; 91: 1893-1897
        • Demetriades D.
        • Murray J.
        • Charalambides K.
        • Alo K.
        • Velmahos G.
        • Rhee P.
        • et al.
        Trauma fatalities: time and location of hospital deaths.
        J Am Coll Surg. 2004; 198: 20-26
        • Loh S.A.
        • Rockman C.B.
        • Chung C.
        • Maldonado T.S.
        • Adelman M.A.
        • Cayne N.S.
        • et al.
        Existing trauma and critical care scoring systems underestimate mortality among vascular trauma patients.
        J Vasc Surg. 2011; 53: 359-366
        • Hollands M.J.
        • Little J.M.
        Hepatic venous injury after blunt abdominal trauma.
        Surgery. 1990; 107: 149-152
        • Kauvar D.S.
        • Sarfati M.R.
        • Kraiss L.W.
        National trauma databank analysis of mortality and limb loss in isolated lower extremity vascular trauma.
        J Vasc Surg. 2011; 53: 1598-1603
        • Caps M.T.
        The epidemiology of vascular trauma.
        Semin Vasc Surg. 1998; 11: 227-231
        • Allison N.D.
        • Anderson C.M.
        • Shah S.K.
        • Lally K.P.
        • Hayes-Jordan A.
        • Tsao K.-J.
        • et al.
        Outcomes of truncal vascular injuries in children.
        J Pediatr Surg. 2009; 44: 1958
        • Scottish Trauma Audit Group (STAG)
        Audit of Trauma Management in Scotland 2019; Reporting on 2018.
        2019 (Available at:)