Iliac vessel injury: operative physiology related to outcome

J Trauma. 1997 Jun;42(6):1033-40. doi: 10.1097/00005373-199706000-00008.

Abstract

Background: Fifty-three patients treated at a level I trauma center with iliac vessel injury were studied to determine if body temperature and acid-base status in the operating room predicts outcome.

Methods: Records were reviewed for demographics, mechanism of injury, body temperature, acid-base status, operative management, and outcome. Statistical methods included Student's t test, odds ratio determination, and chi-square analysis to determine statistical significance.

Results: Fifty-three patients (47 male, 6 female) sustained 92 iliac vascular injuries (36 arterial, 56 venous). Mortality was 34%, with 72% of deaths due to shock within 24 hours. Physiologic parameters differed significantly between survivors and nonsurvivors. Odds ratio identified six conditions; the number present predicted outcome.

Conclusions: (1) There are significant differences between initial and final operating room temperature and acid-base status in survivors versus nonsurvivors with iliac vessel injury. Conditions for odds ratio can be calculated and correlated with outcome. (2) A patient with two or more conditions should be considered for an abbreviated laparotomy to allow for reversal of "physiologic failure."

MeSH terms

  • Acid-Base Equilibrium*
  • Adolescent
  • Adult
  • Aged
  • Body Temperature*
  • Child
  • Female
  • Humans
  • Iliac Artery / injuries*
  • Iliac Artery / surgery
  • Iliac Vein / injuries*
  • Iliac Vein / surgery
  • Intraoperative Period
  • Male
  • Middle Aged
  • Multiple Trauma / mortality
  • Multiple Trauma / physiopathology
  • Odds Ratio
  • Postoperative Complications
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Wounds, Gunshot / mortality
  • Wounds, Gunshot / physiopathology
  • Wounds, Penetrating / mortality
  • Wounds, Penetrating / physiopathology*