Predictors of survival after inferior vena cava injuries

Mark P. Ombrellaro, Michael Freeman, Scott Stevens, Daniel L. Diamond, Mitchell Goldman

Research output: Contribution to journalArticle

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Abstract

In patients with inferior vena cava (IVC) injuries, predictors of survival are investigated. From 1987 to 1995, 27 IVC injuries were identified among 514 patients with vascular trauma. The ability of clinical determinants to predict survival were retrospectively assessed. IVC injuries occurred in 7 females and 20 males (mean age, 27.7 ± 2.5 years) from both blunt (n = 14) and penetrating (n = 13) trauma. The mean revised trauma score was 10.2 ± 0.6. Injuries were treated by primary repair (n = 22), ligation (n = 4), or prosthetic grafting (n = 1). Thirteen patients died (48%), 10 within 12 hours of admission. Suprahepatic (n = 2), retrohepatic (n = 12), suprarenal (n = 1), and infrarenal (n = 12) injuries were associated with 100, 67, 100, and 20 per cent mortality, respectively. Blood transfusions (16 ± 4 vs 23 ± 4 units), coagulation factor replacement (7 ± 2 vs 7 ± 2 units), and electrolyte solution use (8.6 ± 1.4 vs 9.6 ± 1.4 L) were similar among survivors and nonsurvivors. Four complications [venous hypertension (n = 2), IVC thrombosis (n = 1), and pulmonary embolus (n = 1)] occurred in the 14 survivors (28.6%). Blunt injury, revised trauma score, free perforation, injury location, intraoperative hypotension, and blood loss were predictive of mortality. IVC injuries remain extremely lethal, and improved survival is associated with infrarenal penetrating injuries and a contained hematoma.

Original languageEnglish (US)
Pages (from-to)178-183
Number of pages6
JournalAmerican Surgeon
Volume63
Issue number2
StatePublished - 1997

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Inferior Vena Cava
Survival
Wounds and Injuries
Survivors
Nonpenetrating Wounds
Blood Coagulation Factors
Mortality
Embolism
Blood Transfusion
Hematoma
Hypotension
Electrolytes
Ligation
Blood Vessels
Thrombosis
Hypertension

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Predictors of survival after inferior vena cava injuries. / Ombrellaro, Mark P.; Freeman, Michael; Stevens, Scott; Diamond, Daniel L.; Goldman, Mitchell.

In: American Surgeon, Vol. 63, No. 2, 1997, p. 178-183.

Research output: Contribution to journalArticle

Ombrellaro, Mark P. ; Freeman, Michael ; Stevens, Scott ; Diamond, Daniel L. ; Goldman, Mitchell. / Predictors of survival after inferior vena cava injuries. In: American Surgeon. 1997 ; Vol. 63, No. 2. pp. 178-183.
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