title: Analysis of 185 iliac vessel injuries: risk factors and predictors of outcome.
abstract: OBJECTIVE
  Iliac vascular injuries incur high mortality.
  
  
  METHODS
  Retrospective 100-month study (January 1, 1992, through April 30, 2000).
  
  
  METHODS
  One hundred forty-eight patients with 185 iliac vessel injuries.
  
  
  METHODS
  Survival and mortality, analyzed by univariate and logistic regression.
  
  
  RESULTS
  Admission mean +/- SD systolic blood pressure was 81 +/- 42 mm Hg, mean Revised Trauma Score was 6.0 +/- 2.8, and mean Injury Severity Score was 20.0 +/- 9.5. The mechanism of injury was penetrating in 140 patients (95%) and blunt in 8 (5%). The mean estimated blood loss was 6246 +/- 6174 mL. Of the 185 injured vessels, 71 (99%) of 72 iliac arteries were repaired, 101 (89%) of 113 iliac veins were ligated, and 12 (11%) of 113 iliac veins were repaired. Overall survival was 51% (76/148). Mortality was 82% (49/72) in patients with exsanguination. Survival by vessel: iliac artery, 57% (20/35); iliac vein, 55% (42/76); and iliac artery and vein, 38% (14/37). Significant predictors of outcome were thoracotomy in the emergency department, associated aortic injury, inferior vena cava injuries, iliac artery and vein injury, intraoperative arrhythmia, and intraoperative coagulopathy. On logistic regression, independent risk factors for survival were absence of thoracotomy in the emergency department, surgical management, and arrhythmia. Mortality by grade on the Organ Injury Scale of the American Association for the Surgery of Trauma (AAST-OIS) was as follows: grade III, 35% (33/95); grade IV, 71% (24/34); and grade V, 79% (15/19).
  
  
  CONCLUSIONS
  Mortality remains high. Associated vessel injuries and intraoperative complications predict mortality. AAST-OIS grade for abdominal vascular injuries correlates well with mortality.
authors: Department of Surgery, Division of Trauma and Critical Care, Los Angeles County, and University of Southern California Medical Center, Los Angeles 90033, USA. asensio@hsc.usc.edu
authors: Juan A
authors: JA
authors: Asensio
authors: Patrizio
authors: P
authors: Petrone
authors: Gustavo
authors: G
authors: Roldán
authors: Eric
authors: E
authors: Kuncir
authors: Vincent L
authors: VL
authors: Rowe
authors: Linda
authors: L
authors: Chan
authors: William
authors: W
authors: Shoemaker
authors: Thomas V
authors: TV
authors: Berne
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000293:injuries* / Q000601:surgery; D007084:Iliac Vein / Q000293:injuries* / Q000601:surgery; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery