Trends in Open Vascular Surgery For Trauma: Implications for the Future of Acute Care Surgery

Background Trauma patients with vascular injuries have historically been within a general surgeon’s operative ability. Changes in training and decline in operative trauma have decreased trainees’ exposure to these injuries. We sought to determine how frequently vascular procedures are performed at U...

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Bibliographic Details
Published in:The Journal of surgical research 2016-09, Vol.205 (1), p.208-212
Main Authors: Forrester, Joseph D., MD, MSc, Weiser, Thomas G., MD, MPH, Maggio, Paul, MD, MBA, Browder, Timothy, MD, Tennakoon, Lakshika, MSc, Spain, David, MD, Staudenmayer, Kristan, MD, MS
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Emergency Medical Services - statistics & numerical data
Emergency Medical Services - trends
Female
General Surgery - statistics & numerical data
General Surgery - trends
Humans
Male
Middle Aged
Open vascular repair
Resident training
Retrospective Studies
Surgery
Trauma
Trauma Centers - statistics & numerical data
Trauma Centers - trends
Vascular surgery
Vascular Surgical Procedures - trends
Vascular trauma
Young Adult
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Summary:Background Trauma patients with vascular injuries have historically been within a general surgeon’s operative ability. Changes in training and decline in operative trauma have decreased trainees’ exposure to these injuries. We sought to determine how frequently vascular procedures are performed at U.S. trauma centers to quantify the need for general surgeons trained to manage vascular injuries. Methods We conducted a retrospective analysis of the National Trauma Data Base® (NTDB) from 2012 compared to 2002. Patients with general surgical and vascular procedures were identified using International Classification of Diseases, 9th Revision, procedure codes 38.0-39.99, excluding 38.9-38.99. Results General surgery or vascular operations were performed on 12,099 (24%) of 50,248 severely-injured adult patients in 2002, and 21,854 (16%) of 138,009 injured patients in 2012. Nineteen to 26% of all patients underwent vascular procedures. Patients with combined general surgery and vascular procedures were less likely to be discharged home and more likely to die. In 2002, 6% of severely-injured adult trauma patients underwent open vascular procedures at Level III/IV trauma centers; by 2012 only 1% of vascular surgery procedures were performed at Level III/IV centers (p
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2016.06.032