Objective
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.
Methods
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.
Results
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.
Conclusion
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.
Keywords
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Article info
Publication history
Published online: December 01, 2022
Accepted:
November 26,
2022
Received:
January 30,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
Crown Copyright © 2022 Published by Elsevier B.V. on behalf of European Society for Vascular Surgery. All rights reserved.
