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Iatrogenic and non-iatrogenic vascular trauma in a district general hospital: a 21-year review.

机译:某地区综合医院的医源性和非医源性血管创伤:21年回顾。

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BACKGROUND: Vascular trauma is associated with significant mortality and severe complications. Vascular injuries in the UK are infrequent, although the exact incidence remains unknown. The objective of this article is to describe patients presenting with vascular trauma to one surgeon over 21 years in a British hospital. METHODS: A retrospective review of prospectively collected data was performed and supplemented by case notes retrieval. Patients' details, including cause and nature of vascular injury, intervention, and long-term survival, were recorded. Statistical analysis was performed by comparison of survival curves using a log-rank test. RESULTS: Eighty-nine patients presented, including 44 men (49%). Iatrogenic trauma accounted for 63 cases (71%) with a median age of 63 years (range = 33-91), and 51 of these cases (81%) occurred either following peripheral angioplasty (n = 40) or after cardiac catheterisation (n = 11). Within the non-iatrogenic group (n = 26), median age was 35 years (range = 15-71), with 19 cases (58%) situated in the lower limb. There were no amputations. Median survival of patients following peripheral vascular intervention was 83 months, compared with 180 months following coronary procedures. No patient died following non-iatrogenic trauma. CONCLUSION: Vascular trauma remains a serious although uncommon phenomenon, with a trend in the UK of increasing iatrogenic trauma. To ensure the best possible outcomes, future rotas and designation of services will need to guarantee the consistent availability of a vascular surgeon. A British national registry on vascular trauma is currently lacking and would assist in identifying national trends and comparing international outcomes and epidemiology.
机译:背景:血管外伤与高死亡率和严重并发症有关。尽管确切的发病率仍然未知,但在英国很少发生血管损伤。本文的目的是描述21年来在英国一家医院中对一名外科医生出现血管创伤的患者。方法:对前瞻性收集的数据进行回顾性回顾,并辅以病例笔记检索。记录患者的详细信息,包括血管损伤的原因和性质,干预和长期生存。通过使用对数秩检验比较生存曲线进行统计分析。结果:共有89例患者参加,其中包括44名男性(占49%)。医源性创伤占63例(71%),中位年龄为63岁(范围= 33-91),其中51例(81%)发生于周围血管成形术(n = 40)或心脏置管后(n = 11)。在非医源性组(n = 26)中,中位年龄为35岁(范围= 15-71),下肢有19例(58%)。没有截肢。周围血管介入治疗后患者的中位生存期为83个月,而冠状动脉手术后为180个月。没有患者因非医源性创伤而死亡。结论:血管外伤仍然是一种严重的现象,尽管不常见,但在英国,医源性外伤的趋势有所增加。为了确保可能的最佳结果,将来的花名册和服务指定将需要保证血管外科医师的持续可用性。目前缺乏英国关于血管创伤的国家注册机构,这将有助于确定国家趋势并比较国际结果和流行病学。

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