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Role of endovascular management on outcomes in patients with traumatic inferior vena cava injuries
The aim of this study was to examine the association between the injury mechanism and repair type with outcomes in patients with traumatic inferior vena cava injuries. This is a retrospective analysis of the ACS-TQIP database (2017–2020), including patients with traumatic IVC injuries. Patients were...
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| Published in: | The American journal of surgery 2024-12, Vol.238, p.115836, Article 115836 |
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| container_title | The American journal of surgery |
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| creator | O'Connor, Devin Hejazi, Omar Colosimo, Christina Stewart, Collin Hosseinpour, Hamid Khurshid, Muhamad Nelson, Adam C. Joseph, Bellal Bhogadi, Sai K. Anand, Tanya Spencer, Audrey L. Magnotti, Louis J. |
| description | The aim of this study was to examine the association between the injury mechanism and repair type with outcomes in patients with traumatic inferior vena cava injuries.
This is a retrospective analysis of the ACS-TQIP database (2017–2020), including patients with traumatic IVC injuries. Patients were stratified by injury mechanism and type of repair and compared.
Out of 1334 patients, 5 % underwent endovascular repair while 95 % had an open procedure. Overall, 74.7 % sustained a penetrating injury. On multivariable regression analysis, the type of repair was not associated with mortality and morbidity for patients with penetrating injuries. However, among patients with blunt injuries, endovascular repair was associated with lower odds of in-hospital mortality (aOR:0.35, p = 0.020) and non-venous thromboembolism (VTE) morbidity (aOR:0.41, p = 0.015), and higher odds of VTE complications (aOR:6.74, p |
| doi_str_mv | 10.1016/j.amjsurg.2024.115836 |
| format | article |
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This is a retrospective analysis of the ACS-TQIP database (2017–2020), including patients with traumatic IVC injuries. Patients were stratified by injury mechanism and type of repair and compared.
Out of 1334 patients, 5 % underwent endovascular repair while 95 % had an open procedure. Overall, 74.7 % sustained a penetrating injury. On multivariable regression analysis, the type of repair was not associated with mortality and morbidity for patients with penetrating injuries. However, among patients with blunt injuries, endovascular repair was associated with lower odds of in-hospital mortality (aOR:0.35, p = 0.020) and non-venous thromboembolism (VTE) morbidity (aOR:0.41, p = 0.015), and higher odds of VTE complications (aOR:6.74, p < 0.001).
Although the type of repair did not impact morbidity and mortality in patients with penetrating injuries, endovascular repair was identified as the only modifiable predictor of reduced non-VTE morbidity and mortality in patients with blunt injuries.
•Vena Cava Injuries (VCI) result in significant morbidity and mortality regardless of the mechanism of injury.•Type of repair (open vs endovascular) does not impact morbidity and mortality in patients with penetrating VCI.•Endovascular repair is associated with reduced mortality and non-venous thromboembolism (VTE) morbidity in blunt VCI patients.•Endovascular repair is associated with higher risk-adjusted odds of VTE complications among blunt VCI.</description><identifier>ISSN: 0002-9610</identifier><identifier>ISSN: 1879-1883</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2024.115836</identifier><identifier>PMID: 39163763</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Blood pressure ; Blunt/penetrating trauma ; Cardiovascular system ; Endovascular Procedures - methods ; Fabric analysis ; Female ; Gender ; Hospital Mortality ; Humans ; Injuries ; Injury analysis ; Laparotomy ; Male ; Middle Aged ; Morbidity ; Mortality ; Open vs endovascular repair ; Patients ; Regression analysis ; Retrospective Studies ; Surgeons ; Thromboembolism ; Trauma ; Treatment Outcome ; Vascular System Injuries - mortality ; Vascular System Injuries - surgery ; Vena cava injuries ; Vena Cava, Inferior - injuries ; Wounds, Nonpenetrating - complications ; Wounds, Nonpenetrating - mortality ; Wounds, Nonpenetrating - surgery ; Wounds, Nonpenetrating - therapy ; Wounds, Penetrating - complications ; Wounds, Penetrating - mortality ; Wounds, Penetrating - surgery</subject><ispartof>The American journal of surgery, 2024-12, Vol.238, p.115836, Article 115836</ispartof><rights>2024</rights><rights>Copyright © 2024. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Dec 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c271t-9cea6ca26050e3cb48055e22a43b3c46691a2b491eea62a109806525b86e35a93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39163763$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Connor, Devin</creatorcontrib><creatorcontrib>Hejazi, Omar</creatorcontrib><creatorcontrib>Colosimo, Christina</creatorcontrib><creatorcontrib>Stewart, Collin</creatorcontrib><creatorcontrib>Hosseinpour, Hamid</creatorcontrib><creatorcontrib>Khurshid, Muhamad</creatorcontrib><creatorcontrib>Nelson, Adam C.</creatorcontrib><creatorcontrib>Joseph, Bellal</creatorcontrib><creatorcontrib>Bhogadi, Sai K.</creatorcontrib><creatorcontrib>Anand, Tanya</creatorcontrib><creatorcontrib>Spencer, Audrey L.</creatorcontrib><creatorcontrib>Magnotti, Louis J.</creatorcontrib><title>Role of endovascular management on outcomes in patients with traumatic inferior vena cava injuries</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>The aim of this study was to examine the association between the injury mechanism and repair type with outcomes in patients with traumatic inferior vena cava injuries.
This is a retrospective analysis of the ACS-TQIP database (2017–2020), including patients with traumatic IVC injuries. Patients were stratified by injury mechanism and type of repair and compared.
Out of 1334 patients, 5 % underwent endovascular repair while 95 % had an open procedure. Overall, 74.7 % sustained a penetrating injury. On multivariable regression analysis, the type of repair was not associated with mortality and morbidity for patients with penetrating injuries. However, among patients with blunt injuries, endovascular repair was associated with lower odds of in-hospital mortality (aOR:0.35, p = 0.020) and non-venous thromboembolism (VTE) morbidity (aOR:0.41, p = 0.015), and higher odds of VTE complications (aOR:6.74, p < 0.001).
Although the type of repair did not impact morbidity and mortality in patients with penetrating injuries, endovascular repair was identified as the only modifiable predictor of reduced non-VTE morbidity and mortality in patients with blunt injuries.
•Vena Cava Injuries (VCI) result in significant morbidity and mortality regardless of the mechanism of injury.•Type of repair (open vs endovascular) does not impact morbidity and mortality in patients with penetrating VCI.•Endovascular repair is associated with reduced mortality and non-venous thromboembolism (VTE) morbidity in blunt VCI patients.•Endovascular repair is associated with higher risk-adjusted odds of VTE complications among blunt VCI.</description><subject>Adult</subject><subject>Blood pressure</subject><subject>Blunt/penetrating trauma</subject><subject>Cardiovascular system</subject><subject>Endovascular Procedures - methods</subject><subject>Fabric analysis</subject><subject>Female</subject><subject>Gender</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Injuries</subject><subject>Injury analysis</subject><subject>Laparotomy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Open vs endovascular repair</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Surgeons</subject><subject>Thromboembolism</subject><subject>Trauma</subject><subject>Treatment Outcome</subject><subject>Vascular System Injuries - mortality</subject><subject>Vascular System Injuries - surgery</subject><subject>Vena cava injuries</subject><subject>Vena Cava, Inferior - injuries</subject><subject>Wounds, Nonpenetrating - complications</subject><subject>Wounds, Nonpenetrating - mortality</subject><subject>Wounds, Nonpenetrating - surgery</subject><subject>Wounds, Nonpenetrating - therapy</subject><subject>Wounds, Penetrating - complications</subject><subject>Wounds, Penetrating - mortality</subject><subject>Wounds, Penetrating - surgery</subject><issn>0002-9610</issn><issn>1879-1883</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkUGLFDEQhYMo7rj6E5SAl730mEo6meQksriusCDIeg7VmZo1TXdnTLpH_PebYUYPXvZU1MtXVeE9xt6CWIMA86Ff49iXJT-spZDtGkBbZZ6xFdiNa8Ba9ZythBCycQbEBXtVSl9bgFa9ZBfKgVEbo1as-54G4mnHadqmA5awDJj5iBM-0EjTzNPE0zKHNFLhceJ7nGOVC_8d5598zriMVQn1aUc5pswPNCEPeMAq9UuOVF6zFzscCr0510v24-bz_fVtc_fty9frT3dNkBuYGxcITUBphBakQtdaoTVJia3qVGiNcYCyax1Q5SSCcFYYLXVnDSmNTl2yq9PefU6_FiqzH2MJNAw4UVqKV8Jp2Cjtjuj7_9A-LXmqv_MKFFiorK2UPlEhp1Iy7fw-xxHzHw_CH0PwvT-H4I8h-FMIde7defvSjbT9N_XX9Qp8PAFU7ThEyr6E6mqgbcwUZr9N8YkTj_ntmto</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>O'Connor, Devin</creator><creator>Hejazi, Omar</creator><creator>Colosimo, Christina</creator><creator>Stewart, Collin</creator><creator>Hosseinpour, Hamid</creator><creator>Khurshid, Muhamad</creator><creator>Nelson, Adam C.</creator><creator>Joseph, Bellal</creator><creator>Bhogadi, Sai K.</creator><creator>Anand, Tanya</creator><creator>Spencer, Audrey L.</creator><creator>Magnotti, Louis J.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>202412</creationdate><title>Role of endovascular management on outcomes in patients with traumatic inferior vena cava injuries</title><author>O'Connor, Devin ; Hejazi, Omar ; Colosimo, Christina ; Stewart, Collin ; Hosseinpour, Hamid ; Khurshid, Muhamad ; Nelson, Adam C. ; Joseph, Bellal ; Bhogadi, Sai K. ; Anand, Tanya ; Spencer, Audrey L. ; Magnotti, Louis J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c271t-9cea6ca26050e3cb48055e22a43b3c46691a2b491eea62a109806525b86e35a93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Blood pressure</topic><topic>Blunt/penetrating trauma</topic><topic>Cardiovascular system</topic><topic>Endovascular Procedures - methods</topic><topic>Fabric analysis</topic><topic>Female</topic><topic>Gender</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Injuries</topic><topic>Injury analysis</topic><topic>Laparotomy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Open vs endovascular repair</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Surgeons</topic><topic>Thromboembolism</topic><topic>Trauma</topic><topic>Treatment Outcome</topic><topic>Vascular System Injuries - mortality</topic><topic>Vascular System Injuries - surgery</topic><topic>Vena cava injuries</topic><topic>Vena Cava, Inferior - injuries</topic><topic>Wounds, Nonpenetrating - complications</topic><topic>Wounds, Nonpenetrating - mortality</topic><topic>Wounds, Nonpenetrating - surgery</topic><topic>Wounds, Nonpenetrating - therapy</topic><topic>Wounds, Penetrating - complications</topic><topic>Wounds, Penetrating - mortality</topic><topic>Wounds, Penetrating - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Connor, Devin</creatorcontrib><creatorcontrib>Hejazi, Omar</creatorcontrib><creatorcontrib>Colosimo, Christina</creatorcontrib><creatorcontrib>Stewart, Collin</creatorcontrib><creatorcontrib>Hosseinpour, Hamid</creatorcontrib><creatorcontrib>Khurshid, Muhamad</creatorcontrib><creatorcontrib>Nelson, Adam C.</creatorcontrib><creatorcontrib>Joseph, Bellal</creatorcontrib><creatorcontrib>Bhogadi, Sai K.</creatorcontrib><creatorcontrib>Anand, Tanya</creatorcontrib><creatorcontrib>Spencer, Audrey L.</creatorcontrib><creatorcontrib>Magnotti, Louis J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Connor, Devin</au><au>Hejazi, Omar</au><au>Colosimo, Christina</au><au>Stewart, Collin</au><au>Hosseinpour, Hamid</au><au>Khurshid, Muhamad</au><au>Nelson, Adam C.</au><au>Joseph, Bellal</au><au>Bhogadi, Sai K.</au><au>Anand, Tanya</au><au>Spencer, Audrey L.</au><au>Magnotti, Louis J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of endovascular management on outcomes in patients with traumatic inferior vena cava injuries</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2024-12</date><risdate>2024</risdate><volume>238</volume><spage>115836</spage><pages>115836-</pages><artnum>115836</artnum><issn>0002-9610</issn><issn>1879-1883</issn><eissn>1879-1883</eissn><abstract>The aim of this study was to examine the association between the injury mechanism and repair type with outcomes in patients with traumatic inferior vena cava injuries.
This is a retrospective analysis of the ACS-TQIP database (2017–2020), including patients with traumatic IVC injuries. Patients were stratified by injury mechanism and type of repair and compared.
Out of 1334 patients, 5 % underwent endovascular repair while 95 % had an open procedure. Overall, 74.7 % sustained a penetrating injury. On multivariable regression analysis, the type of repair was not associated with mortality and morbidity for patients with penetrating injuries. However, among patients with blunt injuries, endovascular repair was associated with lower odds of in-hospital mortality (aOR:0.35, p = 0.020) and non-venous thromboembolism (VTE) morbidity (aOR:0.41, p = 0.015), and higher odds of VTE complications (aOR:6.74, p < 0.001).
Although the type of repair did not impact morbidity and mortality in patients with penetrating injuries, endovascular repair was identified as the only modifiable predictor of reduced non-VTE morbidity and mortality in patients with blunt injuries.
•Vena Cava Injuries (VCI) result in significant morbidity and mortality regardless of the mechanism of injury.•Type of repair (open vs endovascular) does not impact morbidity and mortality in patients with penetrating VCI.•Endovascular repair is associated with reduced mortality and non-venous thromboembolism (VTE) morbidity in blunt VCI patients.•Endovascular repair is associated with higher risk-adjusted odds of VTE complications among blunt VCI.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39163763</pmid><doi>10.1016/j.amjsurg.2024.115836</doi></addata></record> |
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| source | ScienceDirect Journals |
| subjects | Adult Blood pressure Blunt/penetrating trauma Cardiovascular system Endovascular Procedures - methods Fabric analysis Female Gender Hospital Mortality Humans Injuries Injury analysis Laparotomy Male Middle Aged Morbidity Mortality Open vs endovascular repair Patients Regression analysis Retrospective Studies Surgeons Thromboembolism Trauma Treatment Outcome Vascular System Injuries - mortality Vascular System Injuries - surgery Vena cava injuries Vena Cava, Inferior - injuries Wounds, Nonpenetrating - complications Wounds, Nonpenetrating - mortality Wounds, Nonpenetrating - surgery Wounds, Nonpenetrating - therapy Wounds, Penetrating - complications Wounds, Penetrating - mortality Wounds, Penetrating - surgery |
| title | Role of endovascular management on outcomes in patients with traumatic inferior vena cava injuries |
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