Abstract
Background. The mortality rate for abdominal vena caval injuries remains high. We examined the
experience of a level I trauma center to determine factors significant to the outcome
in these injuries. Methods. Forty-seven patients were identified in a retrospective review (1989 to 1999) of
patients were identified with abdominal vena caval injury. Data were analyzed by uni-
and multivariate methods, including logistic regression. Results. Most of the individuals with abdominal vena caval injuries were young male patients
who were injured by penetrating trauma and who were hypotensive on arrival. The severity
of injury and the number of organs injured was high. The overall mortality rate was
55%. Nonsurvivors were more often hypotensive in the field with physiologic derangement
consistent with hemorrhagic shock. Type and location of injury as well as method of
repair were associated with death. Multiple regression analysis revealed that prehospital
initial systolic blood pressure and intraoperative bicarbonate levels were independent
predictors of survival. Conclusions. We identified factors related to poor outcome, including suprarenal and retrohepatic
location of injury and variables that reflected the evolution of shock. Management
should include appropriate resuscitation and ultimately may require novel operative
techniques. (Surgery 2000;128:572-8.)
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Article info
Footnotes
*Reprint requests: Jorge L. Rodriguez, MD, Department of Surgery, Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415.
**Surgery 2000;128:572-8
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
