Abstract
BackgroundVascular damage in polytrauma patients is associated with high mortality and morbidity. Therefore, specific clinical implications of vascular damage with fractures in major trauma patients are reassessed.MethodsThis comprehensive nine-year retrospective single center cohort study analyzed demography, laboratory, treatment and outcome data from 3689 patients, 64 patients with fracture-associated vascular injuries were identified and were compared to a control group.Results: Vascular damage occurred in 7% of patients with upper and lower limb and pelvic fractures admitted to the trauma room. Overall survival was 80% in pelvic fracture and 97% in extremity fracture patients and comparable to non-vascular trauma patients. Additional arterial damage required substantial fluid administration and was visible as significantly anemia and disturbed coagulation tests upon admission. Open procedures were done in over 80% of peripheral extremity vascular damage. Endovascular procedures were predominant (87%) in pelvic injury.ConclusionVascular damage is associated with high mortality rates especially in combination with pelvic fractures. Initial anemia, disturbed coagulation tests and the need for extensive pre-clinical fluid substitution were observed in the cohort with vascular damage. Therefore, fast diagnosis and early interventional and surgical procedures are necessary to optimize patient-specific outcome.
Highlights
Vascular damage in polytrauma patients is associated with high mortality and morbidity
Vascular damage associated with a corresponding fracture of the extremities or the pelvis, requiring specific vascular repair, was identified in 64 cases (Fig. 1)
Vessel injuries were confined to the arterial system in lower and upper limb, while arterial damage was the reason to treat in 66% in pelvic fractures and venous damage requiring treatment was seen in 34%
Summary
Vascular damage in polytrauma patients is associated with high mortality and morbidity. Specific clinical implications of vascular damage with fractures in major trauma patients are reassessed. Whenever the body’s integrity is compromised by contusion, concussion or fracture, surgical trauma care is necessary for rapid damage control and specific individualized treatment. This remains, a major challenge for clinicians due to varying patterns of injuries and occasional major traumas, requiring urgent, yet. Vascular damage in combination with fractures is associated with higher mortality and inferior outcome, especially due to rapid and voluminous blood loss into pelvic or femoral soft tissue compartments. Correct diagnosis may be difficult due to low body temperature and masking effects of other injuries [8,9,10]
Sign-in/Register to view highlights & summary 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.
