Long-term functional outcomes after blunt cerebrovascular injury

A 20-year experience

Charles P. Shahan, Taylor C. Stavely, Martin Croce, Timothy C. Fabian, Louis J. Magnotti

Research output: Contribution to journalArticle

Abstract

Since blunt cerebrovascular injury (BCVI) became increasingly recognized more than 20 years ago, significant improvements have been made in both diagnosis and treatment. Little is known regarding long-term functional outcomes in BCVI. The purpose of this study was to evaluate the impact of BCVI on those long-term outcomes. All patients with BCVI from 1996 to 2014 were identified from the trauma registry. Functional outcome was measured using the Boston University Activity Measure for Post-Acute Care. Multiple regression analysis was performed to identify potential predictors of outcomes. A total of 509 patients were identified. Overall mortality was 18 per cent (BCVI-related 5 1%). Of the 415 survivors, follow-up was obtained in 77 (19%). Mean follow-up was five years, with a maximum of 19 years. Mean age and injury severity score were 47 and 25, respectively. Six (8%) patients suffered strokes. Mean Activity Measure for Post-Acute Care scores were 59 (mobility), 58 (activity), and 44 (cognitive function), each indicating significant impairment compared with normal. Multiple regression models identified 1) age as a predictor of decreased mobility, 2) injury severity score as a predictor of decreased mobility, activity, and cognitive function, and 3) stroke as a predictor of decreased activity, cognitive function, and likely mobility. Development of stroke and increased injury severity resulted in worse long-term functional outcomes after BCVI. Thus, stroke prevention with optimal diagnostic and treatment algorithms remains critical in the successful treatment of BCVI because it has significant impact on long-term functional outcomes and is the only modifiable predictor of outcomes in patients after BCVI.

Original languageEnglish (US)
Pages (from-to)551-556
Number of pages6
JournalAmerican Surgeon
Volume84
Issue number4
StatePublished - Apr 1 2018

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Nonpenetrating Wounds
Subacute Care
Stroke
Cognition
Injury Severity Score
Wounds and Injuries
Survivors
Registries
Therapeutics
Regression Analysis
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Shahan, C. P., Stavely, T. C., Croce, M., Fabian, T. C., & Magnotti, L. J. (2018). Long-term functional outcomes after blunt cerebrovascular injury: A 20-year experience. American Surgeon, 84(4), 551-556.

Long-term functional outcomes after blunt cerebrovascular injury : A 20-year experience. / Shahan, Charles P.; Stavely, Taylor C.; Croce, Martin; Fabian, Timothy C.; Magnotti, Louis J.

In: American Surgeon, Vol. 84, No. 4, 01.04.2018, p. 551-556.

Research output: Contribution to journalArticle

Shahan, CP, Stavely, TC, Croce, M, Fabian, TC & Magnotti, LJ 2018, 'Long-term functional outcomes after blunt cerebrovascular injury: A 20-year experience', American Surgeon, vol. 84, no. 4, pp. 551-556.
Shahan CP, Stavely TC, Croce M, Fabian TC, Magnotti LJ. Long-term functional outcomes after blunt cerebrovascular injury: A 20-year experience. American Surgeon. 2018 Apr 1;84(4):551-556.
Shahan, Charles P. ; Stavely, Taylor C. ; Croce, Martin ; Fabian, Timothy C. ; Magnotti, Louis J. / Long-term functional outcomes after blunt cerebrovascular injury : A 20-year experience. In: American Surgeon. 2018 ; Vol. 84, No. 4. pp. 551-556.
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