Iliac vessel injury: operative physiology related to outcome.
BACKGROUND
Fifty-three patients treated at a level I trauma center with iliac vessel injury were studied to determine if body temperature and acid-base status in the operating room predicts outcome.


METHODS
Records were reviewed for demographics, mechanism of injury, body temperature, acid-base status, operative management, and outcome. Statistical methods included Student's t test, odds ratio determination, and chi-square analysis to determine statistical significance.


RESULTS
Fifty-three patients (47 male, 6 female) sustained 92 iliac vascular injuries (36 arterial, 56 venous). Mortality was 34%, with 72% of deaths due to shock within 24 hours. Physiologic parameters differed significantly between survivors and nonsurvivors. Odds ratio identified six conditions; the number present predicted outcome.


CONCLUSIONS
(1) There are significant differences between initial and final operating room temperature and acid-base status in survivors versus nonsurvivors with iliac vessel injury. Conditions for odds ratio can be calculated and correlated with outcome. (2) A patient with two or more conditions should be considered for an abbreviated laparotomy to allow for reversal of "physiologic failure."
Cushman
J G
JG
Department of Surgery, Emory University School of Medicine/Grady Memorial Hospital, Atlanta, Georgia, USA.
Feliciano
D V
DV
Renz
B M
BM
Ingram
W L
WL
Ansley
J D
JD
Clark
W S
WS
Rozycki
G S
GS
D000136:Acid-Base Equilibrium; D000293:Adolescent; D000328:Adult; D000368:Aged; D001831:Body Temperature; D002648:Child; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000293:injuries* / Q000601:surgery; D007084:Iliac Vein / Q000293:injuries* / Q000601:surgery; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality / Q000503:physiopathology; D016017:Odds Ratio; D011183:Postoperative Complications; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000401:mortality / Q000503:physiopathology; D014950:Wounds, Penetrating / Q000401:mortality / Q000503:physiopathology*