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


CONCLUSIONS
Screening should be undertaken for patients at increased risk for BVNI: those with risk factors identified in our regression analysis and factors previously reported.
D000328:Adult; D001921:Brain / Q000098:blood supply; D001955:British Columbia / Q000453:epidemiology; D020212:Carotid Artery Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D016022:Case-Control Studies; D002533:Cerebral Angiography / Q000706:statistics & numerical data; D003663:Decision Trees; D005260:Female; D015600:Glasgow Coma Scale; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D019838:Neck Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology