Blunt vascular neck injuries: diagnosis and outcomes of extracranial vessel injury.

Abstract

BACKGROUND:

Blunt vascular neck injuries (BVNIs) are rare, often occult, and potentially devastating injuries. The purpose of this study was to identify a high-risk group, which would benefit from screening.

METHODS:

Patients with BVNIs were identified from our trauma registry and charts were reviewed. Potential risk factors for BVNI were evaluated by univariate and multivariate logistic regression.

RESULTS:

Thirty-one BVNIs were identified in 22 patients. The stroke rate was 60% and the mortality rate was 25%. Univariate analysis showed Glasgow Coma Scale score < or = 8, head injury (Abbreviated Injury Scale [AIS] score > or = 3), basal skull fracture, facial injury, other neck injury, thorax injury (AIS score > or = 3), abdominal injury, and cervical spine injury to be significant (p < 0.05). The multivariate predictive model had two predictors remaining significant: thorax injury (AIS [thorax] score > or = 3) and Glasgow Coma Scale score < or = 8.

CONCLUSION:

Screening should be undertaken for patients at increased risk for BVNI: those with risk factors identified in our regression analysis and factors previously reported.

• Authors: Elaine C McKevitt, Andrew W Kirkpatrick, Leslie Vertesi, Robert Granger, Richard K Simons
• Journal: The Journal of trauma (J Trauma) Vol. 53 Issue 3 Pg. 472-6 (Sep 2002) ISSN: 0022-5282 [Print] United States
• PMID: 12352483 (Publication Type: Journal Article)

Topics

• Adult
• Brain (blood supply)
• British Columbia (epidemiology)
• Carotid Artery Injuries (diagnosis, diagnostic imaging, epidemiology, pathology)
• Case-Control Studies
• Cerebral Angiography (statistics & numerical data)
• Decision Trees
• Female
• Glasgow Coma Scale
• Hospitals, General (statistics & numerical data)
• Humans
• Injury Severity Score
• Logistic Models
• Male
• Neck Injuries (diagnosis, diagnostic imaging, epidemiology, pathology)
• Outcome Assessment, Health Care
• Practice Guidelines as Topic
• Registries
• Retrospective Studies
• Risk Factors
• Sex Factors
• Tomography, X-Ray Computed (statistics & numerical data)
• Wounds, Nonpenetrating (diagnosis, diagnostic imaging, epidemiology, pathology)