Introduction The aim of our study is to determine factors that predict mortality in patients with traumatic inferior vena cava (IVC) injuries.
Methods A retrospective review of all patients admitted to the University of California, Irvine Medical Center from July 1996 to March 2003 with IVC injuries was performed. Factors associated with mortality were assessed by univariate analysis. Significant variables by univariate analysis were included in a multivariate regression analysis to determine factors predicting mortality. All values are presented as the mean ±SEM, statistical significance was determined at p ≤ 0.05.
Results From July 1996 to March 2003, there were 10,584 trauma admissions. Thirty-six IVC injuries were identified (mean age 28.4 ± 2.4, injury severity score (ISS) = 25.5±2.3, 86% man and 14% woman), accounting for a 0.34% incidence of IVC injuries among all trauma admissions. Of all trauma laparotomies performed, 3.9% included management of IVC injuries.The mortality rate for patients with IVC injury was 56% (n=20), accounting for 5.9% of all trauma deaths. The mechanism of injury in our patient population was blunt 60%, and penetrating 40% [GSW (78%), SW (22%)]. There was no difference in mortality based on mechanism of injury (p=0.7 Fisher's exact test). Univariate analysis demonstrated that non-survivors had a significantly higher defined ISS (32.3±3. vs.16.9±2., p≤0.001) and had lower systolic blood pressure in the emergency department (ED SBP 46±11 mm Hg vs 93±6.2 mm Hg, p=0.001). Multivariate analysis of these factors revealed both ISS (p=0.01) and ED SBP (p=0.006) to be independent predictors of mortality.
Conclusion ISS and ED SBP predict mortality in patients with traumatic IVCI. The mechanism of injury does not affect survival.
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