All five patients who underwent surgical repair for peripheral vascular injury had successful revascularization. The main method for repair was interposition venous graft. One patient of these died secondary to severe find more bleeding from a liver injury (Patient number 10). The sixth patient underwent surgical exploration with ligation of the tibial vessels (patient number 4). All our vascular injured patients had associated fractures except one. Table 3 shows the highest Abbreviated Injury Scale (AIS) in the body regions where vascular injuries occurred. The highest AIS in those regions in the vascular injury group were contributed to the vascular injuries.
The vascular group had significantly higher AIS in the abdomen and lower limbs (Table 3). The vascular injury group had significantly higher median ISS, total hospital stay and percentage of patients who needed ICU admission (Table 4). Three patients died (23%); two due to vascular injuries of Opaganib the liver (patients number 5 and 10) and one with aortic arch rupture (patient number 11). Table 3 Median score Abbreviated Injury Scale (AIS) by body region in vascular and non vascular groups. Area Vascular group Non vascular
group P value Chest 3.5 (1-5) 3 (1-5) 0.07 Abdomen 4 (2-5) 1 (1-4) 0.001 Upper limb 3 (1-3) 2 (1-3) 0.2 Lower limb 3 3 (2-4) < 0.0001 P = Mann Whitney U test Table 4 Severity of injury parameters. Variable Vascular injured patients (n = 13) Non-Vascular injured patients (n = 995) P value ISS 29 (range 9-50) 5 (range 1-45) < 0.0001 Median hospital stay (days) 24 (range 1-73) 3 (range 1-127) < 0.0001 ICU admission No. (%) 9 (69%) 172 (17%) < 0.0001 P = Mann Whitney U test or STK38 Fisher’s Exact test as appropriate Discussion The incidence of vascular injury has increased worldwide during the last
few years with variation in mechanism and pattern in different populations. The commonest mechanism of injury in civilian practice is road traffic collisions while the increase in penetrating vascular trauma is directly related to the surge of interventional vascular procedures . There have been few studies on vascular injuries from our region. The majority of vascular injuries in Saudi Arabia (57%) were caused by blunt trauma and 91% of those were caused by road traffic collisions . Surprisingly, the commonest cause of vascular injury in Kuwait during the period of 1992-2000 was penetrating firearms and stabbing (43%) and only 23% were caused by road traffic collisions. This may reflect the aftermath of the Gulf War on that community . In contrast RTC accounted for about 40% of all vascular traumas in Ireland and Australia [12, 13]. A population based study from Scotland reported an incidence of aortic injuries of 0.3%.