Trends in hospital abdominal aortic aneurysm deaths in Scotland over 10 years, 1996–2005
✍ Scribed by J. A. Young; J. Moore; L. Kerr; H. Burton; P. A. Stonebridge
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 72 KB
- Volume
- 96
- Category
- Article
- ISSN
- 0007-1323
- DOI
- 10.1002/bjs.6508
No coin nor oath required. For personal study only.
✦ Synopsis
Objective: Military vascular injuries are complex limb and life-threatening wounds which pose significant difficulties in pre-hospital and surgical management. Our aim was to provide a comprehensive description of the epidemiology, treatment and outcome of vascular injury amongst service personnel deployed on operations in Afghanistan and Iraq. Method: Analysis of the British Military Trauma Registry was combined with hospital record and post-mortem review of all cases of vascular trauma in deployed service personnel over a 5-year period ending in January 2008. Results: Of 1203 trauma patients, 121 sustained injuries to named vessels. Seventy-seven of 121 died prior to any opportunity for surgical intervention. All 19 patients who sustained an injury to a named vessel in the abdomen or thorax died; 18 did not survive to undergo surgery, one in extremis casualty underwent a thoracotomy and died. Six out of 15 patients with cervical vascular injuries survived to surgical intervention; two died following surgery. Of 87 patients with extremity vascular injuries, 37 survived to surgery with two postoperative deaths. Interventions on 38 limbs included 19 damage control (15 primary amputations, four vessel ligations) and 19 definitive limb revascularisation procedures (11 interposition vein grafts, eight direct repairs) of which four failed, necessitating three amputations.
Conclusion:
In operable patients with extremity injury, amputation or ligation is often required for damage control and preservation of life, but favourable limb salvage rates are achievable in casualties able to withstand revascularisation. Despite marked progress in contemporary battle-field trauma care, torso vascular injury is usually not amenable to surgical intervention.
Trends in hospital abdominal aortic aneurysm deaths in
Scotland over 10 years, 1996-2005