title: Traumatic vascular injuries: who are repairing them and what are the outcomes?
abstract: BACKGROUND
  Traumatic vascular injuries are infrequent but can be devastating. This study characterized their incidence and the need for vascular surgeons in their repair. Outcomes for patients repaired by vascular and trauma surgeons were compared.
  
  
  METHODS
  Patients age ≥14, needing operations for acute traumatic vascular injuries from January 1, 2008 to December 31, 2013 were included.
  
  
  RESULTS
  Of the 27,224 adult trauma patients, 1.4% had vascular injuries needing operations. Trauma surgeons treated 40% of them. The need for repair by vascular surgeons varied based on mechanism, transfer status, injury location, time of injury, trauma staff practice, and experience (P < .05). Patients repaired by vascular surgeons had more transfusions, longer arrival-to-operation time, surgery duration, hospital stay but lower mortality (P < .05). This mortality difference dissipated after excluding early deaths.
  
  
  CONCLUSIONS
  Approximately 3% of trauma patients had vascular injuries. Trauma surgeons treated a significant portion of them; using less resources and achieving similar outcomes in select patients when compared with vascular surgeons.
authors.affiliation: Department of Surgery, MetroHealth Medical Center, Room H939, Hamann Building, 2500 MetroHealth Dr. Cleveland, OH 44109, USA.
authors.forename: Jack C
authors.initials: JC
authors.lastname: He
authors.affiliation: Department of Surgery, MetroHealth Medical Center, Room H939, Hamann Building, 2500 MetroHealth Dr. Cleveland, OH 44109, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Clancy
authors.affiliation: Department of Surgery, MetroHealth Medical Center, Room H939, Hamann Building, 2500 MetroHealth Dr. Cleveland, OH 44109, USA.
authors.forename: David
authors.initials: D
authors.lastname: Schechtman
authors.affiliation: Department of Surgery, MetroHealth Medical Center, Room H939, Hamann Building, 2500 MetroHealth Dr. Cleveland, OH 44109, USA.
authors.forename: Kristen J
authors.initials: KJ
authors.lastname: Conrad-Schnetz
authors.affiliation: Department of Surgery, MetroHealth Medical Center, Room H939, Hamann Building, 2500 MetroHealth Dr. Cleveland, OH 44109, USA. Electronic address: jclaridge@metrohealth.org.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Claridge
mesh_terms: D002983:Clinical Competence; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D012307:Risk Factors; D014193:Trauma Centers; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D057772:Vascular System Injuries / Q000453:epidemiology / Q000601:surgery*; D000078329:Workforce
keywords: Amputation; Graft patency; Mortality; Trauma surgery; Traumatic vascular injury; Vascular surgery