A. Hassan1, P. Rhee1, A. A. Haider1, N. Kulvatunyou1, T. O’Keeffe1, A. Tang1, R. Latifi1, L. Gries1, G. Vercruysse1, F. Randall1, B. Joseph1 1University Of Arizona,Trauma,Tucson, AZ, USA
Introduction:
Studies have associated surgeon’s volume with improved outcomes after elective vascular procedures. However, the difference in outcomes of vascular repairs performed by surgeons from different services has never been studied in trauma. The aim of this study was to compare outcomes between extremity vascular repair performed by vascular and trauma surgeons at a level I trauma center.
Methods:
We performed a 5-year retrospective analysis of all patients with Brachial, Femoral or Popliteal artery injury who presented to our level I trauma center. The operating surgeon was identified from patient medical records along with other details of vascular injuries, radiological findings, operative repairs and complications. Regression analysis was performed to compare outcomes of amputations, complications, mortality and hospital length of stay.
Results:
A total of 76 patients were included. Mean age was 31 ± 13 years; median extremity AIS [IQR] score was 3 [3 – 3], and overall complication, amputation, and mortality rates were 35.5%, 9.2%, and 5.3% respectively. Vascular repairs in 53.9%(41/76) patients were performed by trauma surgeons and in 46.1%(35/76) by vascular surgeons. The details of the injuries and repairs are as in Tabel 1.
After adjusting for possible confounders in regression analysis, there was no difference in outcomes between the two surgeon groups for amputations (OR [95% CI] = 0.50 [0.06 – 4.23], p=0.52), complications (OR [95% CI] = 0.71 [0.24 – 2.10], p=0.54), mortality (OR [95% CI] = 0.49 [0.02 – 13.92], p=0.68) or hospital length of stay (β [95% CI] = -1.25 [-7.18 – 4.67], p=0.67).
Conclusion:
Extremity vascular injuries remain a relatively scarce entity in trauma. Despite differences in the type of injuries and operative repairs performed for extremity vascular injuries, trauma and vascular surgeons provide equivalent level of care for extremity vascular injuries.
