O65: Extremity Trauma in the UK (UK): Vascular Interventions and Surgery in Trauma Audit (VISTA)

Abstract

Abstract Background Extremity injury is the commonest form of vascular trauma but currently there is no national surgical surveillance of operative management and amputation rates. Vascular injury impacts both the young and elderly, with time critical, trauma specific intervention key for limb salvage. Methods Subgroup analysis of a six-month multicentre, prospective audit of vascular injuries to examine procedures for extremity vascular trauma at 27 UK Major Trauma Centres conducted by the National Trauma Research & Innovation Collaborative and Vascular & Endovascular Research Network. Results There were 153 extremity vascular injuries (n=120 patients: 66 upper limb, 81 lower limb) with 92 primary interventions performed (n=86 open: primary repair, bypass or ligation vs. n=6 endovascular). The median age of operated patients was 36 (IQR: 22.5 - 52) years and 74% were male. 51% of injuries operated upon were secondary to blunt trauma with concomitant orthopaedic injury in 33%. Median time to intervention was 169 (IQR: 112 - 371) minutes with a consultant vascular surgeon present in 84% of cases. Overall, there were n=16 amputations: 7% primary and 11% secondary in operative cases. The median age for amputation was 41.5 (IQR: 36 - 52) years. Conclusion Extremity vascular interventions, regardless of aetiology, require national surveillance to assess outcomes and identify targets for improved limb salvage across all UK vascular and trauma networks.