Functional outcomes following blunt cerebrovascular injury

Jennifer M. Dicocco, Timothy Fabian, Katrina P. Emmett, Louis J. Magnotti, Ben L. Zarzaur, Nickalus Khan, Jayna M. Kelly, Martin Croce

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

BACKGROUND: There has been much debate on whom to screen, how to screen, and how to treat blunt cerebrovascular injury (BCVI), but there has been little published on long-term functional outcomes following diagnosis and treatment of BCVI. This study was conducted to address those long-term outcomes. METHODS: Patients with BCVI during a 53-month period ending June 2009 were identified. Charts were reviewed for demographics, associated injuries, treatments, strokes, and in-hospital mortality. Posthospital discharge follow-up was conducted. A structured telephone interview was performed using a functional independence measurement-functional activity measurement questionnaire consisting of 30 questions in seven categories (self-care, sphincter control, mobility, locomotion, communication, psychosocial, and cognitive). Each question was scored from 1 (requires full assistance) to 7 (fully independent). Outcomes were compared by type of BCVI, associated injuries, and stroke. RESULTS: Two hundred twenty-two patients with BCVI were identified. Twenty-four patients died during their initial hospitalization, and an additional 11 patient died after hospital discharge. The 68 patients who completed the interview constituted our study population. Mean follow-up was 35 months. Of a possible 210 points, the mean total score on functional independence measurement and functional activity measurement was 186, 185, and 188 for all patients, carotid artery injuries, and vertebral arteries injuries, respectively. A significant difference was seen when comparing patients with and without strokes (173 and 189, respectively). CONCLUSION: This is the first report of functional outcomes following BCVI. We found that carotid and vertebral artery injuries have similar functional outcomes. As would be expected, the development of stroke led to worse outcomes. This underscores the importance of early diagnosis and initiation of therapy. Prevention of stroke in patients with BCVI leads to near-normal functional outcomes. LEVEL OF EVIDENCE: Epidemiologic/prognostic study, level III.

Original languageEnglish (US)
Pages (from-to)955-960
Number of pages6
JournalJournal of Trauma and Acute Care Surgery
Volume74
Issue number4
DOIs
StatePublished - Apr 1 2013

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Nonpenetrating Wounds
Stroke
Carotid Artery Injuries
Vertebral Artery
Wounds and Injuries
Interviews
Locomotion
Self Care
Hospital Mortality
Epidemiologic Studies
Early Diagnosis
Hospitalization
Therapeutics
Communication
Demography

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Dicocco, J. M., Fabian, T., Emmett, K. P., Magnotti, L. J., Zarzaur, B. L., Khan, N., ... Croce, M. (2013). Functional outcomes following blunt cerebrovascular injury. Journal of Trauma and Acute Care Surgery, 74(4), 955-960. https://doi.org/10.1097/TA.0b013e318287800f

Functional outcomes following blunt cerebrovascular injury. / Dicocco, Jennifer M.; Fabian, Timothy; Emmett, Katrina P.; Magnotti, Louis J.; Zarzaur, Ben L.; Khan, Nickalus; Kelly, Jayna M.; Croce, Martin.

In: Journal of Trauma and Acute Care Surgery, Vol. 74, No. 4, 01.04.2013, p. 955-960.

Research output: Contribution to journalArticle

Dicocco, JM, Fabian, T, Emmett, KP, Magnotti, LJ, Zarzaur, BL, Khan, N, Kelly, JM & Croce, M 2013, 'Functional outcomes following blunt cerebrovascular injury', Journal of Trauma and Acute Care Surgery, vol. 74, no. 4, pp. 955-960. https://doi.org/10.1097/TA.0b013e318287800f
Dicocco JM, Fabian T, Emmett KP, Magnotti LJ, Zarzaur BL, Khan N et al. Functional outcomes following blunt cerebrovascular injury. Journal of Trauma and Acute Care Surgery. 2013 Apr 1;74(4):955-960. https://doi.org/10.1097/TA.0b013e318287800f
Dicocco, Jennifer M. ; Fabian, Timothy ; Emmett, Katrina P. ; Magnotti, Louis J. ; Zarzaur, Ben L. ; Khan, Nickalus ; Kelly, Jayna M. ; Croce, Martin. / Functional outcomes following blunt cerebrovascular injury. In: Journal of Trauma and Acute Care Surgery. 2013 ; Vol. 74, No. 4. pp. 955-960.
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