Abstract
Introduction: IVC diameter in stable trauma patients has been shown in previous studies, using a small number of patients, correlated with increased mortality. IVC size can be detected in trauma patients by ultrasound or CT scan; however, due to body habitus etc., the utility of ultrasound has shown to be limited. Flat IVC is defined as infrarenal transverse to antero-posterior IVC ratio of ≥1.9. We hypothesized that in a large group of “stable” trauma patients that a flat IVC would be a marker of increased mortality and morbidity. Methods: We retrospectively studied 354 adult “stable” trauma patients seen at our urban level 1 trauma center. We analyzed demographic data [age, gender, injury severity score (ISS), revised trauma score (RTS), and shock index (SI)], outcome data [hospital length of stay (HLOS), and survival to hospital discharge], as well as, CT data. We reviewed 354 CT scans for supra-diaphragmatic aorta size to AP thoracic diameter ratio, as well as, supra-renal IVC size. Data were tabulated and analyzed using one-way analysis of variance (ANOVA). Results: Of the 354 patients, we had 339 survivors. Age and gender distribution between survivors and non-survivors was similar. As expected, ISS (31.0 ± 2.2 vs. 8.9 ± 0.5, p=0.0001) and SI (1.9 ± 0.1 vs. 1.6 ± 0.02, p=0.001) were higher in non-survivors as compared to survivors and RTS (8.5 ± 0.02 vs. 11.8 ± 0.05, p=0.001) was lower. Supra-diaphragmatic aorta to AP thoracic diameter ratio was similar between survivors and non-survivors. We noted 141 patients with flat IVC and 213 patients with non-flat IVC. Shock Index between the two groups was not different. However, ISS (12 ± 0.08 vs. 8.5 ± 0.06, p=0.008) was higher, RTS (11.5 ± 0.1 vs. 11.8 ± 0.1, p=0.02) and survival (92.2 ± 1.7% vs. 98.1 ± 1.4%, p=0.007) was lower in the flat IVC group. The hospital length of stay (7.4 ± 1.2 days vs. 4.1 ± 1.0, p=0.04) for the flat IVC group was also longer suggesting increased morbidity. Conclusions: Flat IVC obtained by admission CT scan in “stable” trauma patients correlated with increased mortality and morbidity.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
