Limb outcome and mortality in lower and upper extremity arterial injury: A comparison using the national trauma data bank

Tze Woei Tan, Fernando L. Joglar, Naomi M. Hamburg, Robert T. Eberhardt, Palma M. Shaw, Denis Rybin, Gheorghe Doros, Alik Farber

Research output: Contribution to journalArticlepeer-review

43 Scopus citations

Abstract

Objective: To examine the outcomes of lower extremity (LE) and upper extremity (UE) arterial trauma. Methods: Retrospective review of 2008 version of National Trauma Databank. Adult patient with LE and UE arterial trauma was identified and outcomes were compared. Results: There were 8311 cases of extremity arterial trauma and 37% involved the LE. The LE cohort had higher blunt injury (56.2% vs 37.4%; P <.0001). The LE cohort was more likely to require fasciotomy (23.6% vs 6.7%; P <.0001) and amputation (7.8% vs 1.3%; P <.0001). Complication (18.8% vs 5.1%; P <.0001) and mortality rate (7.7% vs 2.2%, P <.0001) were higher in the LE cohort. Regardless of extremity, blunt trauma was associated with higher mortality (4.8% vs 3.8%; P =.03) and amputation (6.7% vs 1.3%; P <.0001). In multivariable analysis, LE arterial trauma was associated with increased mortality (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.7-2.9; P <.0001) and amputation (OR 4.3, 95% CI 3.2-5.8; P <.0001). Conclusions: Lower and upper extremity arterial injuries have different modes of presentation and outcomes. Lower extremity arterial trauma is more commonly caused by blunt injury and associated with worse outcomes despite more intensive intervention.

Original languageEnglish (US)
Pages (from-to)592-597
Number of pages6
JournalVascular and endovascular surgery
Volume45
Issue number7
DOIs
StatePublished - Oct 2011
Externally publishedYes

Keywords

  • blunt injury
  • extremity arterial trauma
  • extremity vascular trauma
  • outcome

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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