Prevalence and Outcome of Abdominal Vascular Injury in Severe Trauma Patients – An International Registry Analysis

Background: This study details the etiology, frequency and effect of abdominal vascular injuries in patients after polytrauma. Patients and methods All patients of TraumaRegister DGU® with following criteria were included: online documentation of European trauma centers, age 16-85 years, presence of abdominal vascular injury, and AIS ≥ 3. Patients were divided in three groups of: arterial injury only, venous injury only, mixed arterial and venous injuries. Results: A total of 2949 patients were included. All types of vessel injuries were more prevalent in patients with abdominal trauma followed by thoracic trauma. Rate of patients with shock upon admission were the same in patients with arterial injury alone (n= 606, 33%) and venous injury alone (n=95, 32%). Venous trauma showed higher odds ratio for in-hospital mortality (OR: 1.48; 95% CI 1.10-1.98, p=0.010). Conclusion: Abdominal arterial injury and venous injury were equally responsible for the rate of hemodynamic instability at the time of admission. However, the proportion of adverse outcome during hospital stay was significantly higher in patients with venous injury. Stable patients suspected of abdominal vascular injuries should be further investigated to exclude or localize the possible retroperitoneal hematoma caused by subtle venous injury.