Incidence of venous thromboembolism after inferior vena cava injury.
BACKGROUND
Complications after inferior vena cava (IVC) injury, including venous thromboembolism (VTE), are expected, but the exact incidence is poorly defined. The purpose of this study is to examine the VTE rate following ligation versus repair of IVC injuries.


METHODS
The California State Inpatient Database was queried for all adult patients (age >14 y) admitted between 2005 and 2008 with IVC injuries. Demographic data, mechanism of injury, operative technique (ligation versus repair), and outcomes were recorded. Outcomes were compared according to operative technique.


RESULTS
A total of 308 patients with IVC injuries were evaluated. The study population was mostly male (81.2%), young (median age 24 y), and Hispanic (43.2%). Overall mortality was 37.3%. The mechanisms of injury included gunshot wounds (52.3%), stab wounds (14.0%), and motor vehicle collisions (14.9%). Associated injuries were present in 100% of cases, with duodenal injuries being the most common. The majority of injuries were managed by primary repair (76.6%), with ligation performed in 23.4%. Patients who underwent ligation had a longer hospital stay (median 9 versus 6 d, P = 0.04) and a trend towards a higher mortality (45.8% versus 34.8%, P = 0.10), with no difference in VTE rate (4.2% versus 1.7%, P > 0.99).


CONCLUSIONS
As expected, IVC injuries carry a very high mortality rate and are always associated with other injuries. We demonstrated a surprisingly low rate of VTE after operative management for IVC injury, which was similar for patients undergoing ligation and repair.
Division of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA. matthew.singer@cshs.org
Matthew B
MB
Singer
Anoushiravan Amini
AA
Hadjibashi
Marko
M
Bukur
Eric J
EJ
Ley
James
J
Mirocha
Darren J
DJ
Malinoski
Daniel R
DR
Margulies
Ali
A
Salim
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures; D057772:Vascular System Injuries / Q000150:complications* / Q000601:surgery; D014682:Vena Cava, Inferior / Q000293:injuries*; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult