title: Abdominal vascular trauma in 760 severely injured patients.
abstract: OBJECTIVE
  The relevance of abdominal vascular injuries in polytraumatic patients within a large collective has not yet been thoroughly analyzed. This study aimed at assessing the prevalence of traumatic injuries in relation to outcome and currently established treatment options.
  
  
  METHODS
  51,425 patients from the Trauma Registry of the German Society of Trauma Surgery (TR DGU) (1993-2009) were analyzed retrospectively. All patients who had an Injury Severity Score (ISS) of ≥16, were directly admitted to a trauma center and subsequently received treatment for at least three days, were ≥16 years old, and had an abdominal injury (AISabdomen ≥2) were included. Patients with abdominal trauma (AISabdomen ≥2) were compared with patients with additional vascular trauma (AISvascular 2-5).
  
  
  RESULTS
  10,530 (20.5 %) of the 51,425 patients had documented abdominal injury. 760 (7.2 %) of the patients with abdominal injury additionally showed abdominal vascular injury (AISabdomen ≥2, AISvascular 2-5) and were analyzed based on the classification of the American Association for the Surgery of Trauma (AAST) organ severity score (AAST vascular injury grade: II, 2.4 %; III, 2.7 %; IV, 1.8 %; V, 0.2 %. Patients with high-grade abdominal vascular injury (grades IV and V) showed a significant increase in mortality (IV, 44.6 %; V, 60 %) and consequently a decrease in the need for surgical intervention (IV, 67.4 %; V, 64 %).
  
  
  CONCLUSIONS
  The results presented here show the prevalence and outcome of abdominal vascular injuries in a large collective within the TR DGU for the first time. Based on the current literature and these findings, a treatment algorithm has been developed.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, NRW, Germany. matthias.heuer@uk-essen.de.
authors.forename: M
authors.initials: M
authors.lastname: Heuer
authors.affiliation: Department of Trauma Surgery, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, NRW, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Hussmann
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, NRW, Germany.
authors.forename: G M
authors.initials: GM
authors.lastname: Kaiser
authors.affiliation: Faculty of Medicine, Institute for Research in Operative Medicine, University of Witten/Herdecke, Campus Cologne-Merheim, Ostmerheimer Str. 200, 51109, Cologne, NRW, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Lefering
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, NRW, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Paul
authors.affiliation: Department of Trauma Surgery, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, NRW, Germany. sven.lendemans@uk-essen.de.
authors.forename: S
authors.initials: S
authors.lastname: Lendemans
keywords: Abdomen; Mortality; Prognosis; Trauma; Vascular injury
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