title: Limb outcome and mortality in lower and upper extremity arterial injury: a comparison using the National Trauma Data Bank.
abstract: OBJECTIVE
  To examine the outcomes of lower extremity (LE) and upper extremity (UE) arterial trauma.
  
  
  METHODS
  Retrospective review of 2008 version of National Trauma Databank. Adult patient with LE and UE arterial trauma was identified and outcomes were compared.
  
  
  RESULTS
  There were 8311 cases of extremity arterial trauma and 37% involved the LE. The LE cohort had higher blunt injury (56.2% vs 37.4%; P < .0001). The LE cohort was more likely to require fasciotomy (23.6% vs 6.7%; P < .0001) and amputation (7.8% vs 1.3%; P < .0001). Complication (18.8% vs 5.1%; P < .0001) and mortality rate (7.7% vs 2.2%, P < .0001) were higher in the LE cohort. Regardless of extremity, blunt trauma was associated with higher mortality (4.8% vs 3.8%; P = .03) and amputation (6.7% vs 1.3%; P < .0001). In multivariable analysis, LE arterial trauma was associated with increased mortality (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.7-2.9; P < .0001) and amputation (OR 4.3, 95% CI 3.2-5.8; P < .0001).
  
  
  CONCLUSIONS
  Lower and upper extremity arterial injuries have different modes of presentation and outcomes. Lower extremity arterial trauma is more commonly caused by blunt injury and associated with worse outcomes despite more intensive intervention.
authors: Section of Vascular and Endovascular Surgery, Boston University Medical Center and Boston University School of Public Health, Boston, MA 02119, USA.
authors: Tze-Woei
authors: TW
authors: Tan
authors: Fernando L
authors: FL
authors: Joglar
authors: Naomi M
authors: NM
authors: Hamburg
authors: Robert T
authors: RT
authors: Eberhardt
authors: Palma M
authors: PM
authors: Shaw
authors: Denis
authors: D
authors: Rybin
authors: Gheorghe
authors: G
authors: Doros
authors: Alik
authors: A
authors: Farber
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000401:mortality; D001158:Arteries / Q000293:injuries / Q000601:surgery; D016009:Chi-Square Distribution; D019992:Databases as Topic; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D023821:Limb Salvage / Q000401:mortality; D016015:Logistic Models; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D034941:Upper Extremity / Q000098:blood supply*; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality*; D057772:Vascular System Injuries / Q000401:mortality* / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000401:mortality* / Q000601:surgery*; D055815:Young Adult