M. Hamidi1, M. Zeeshan1, N. Kulvatunyou1, T. O’Keeffe1, A. Northcutt1, A. Tang1, E. Zakaria1, L. Gries1, B. Joseph1 1University Of Arizona,Trauma And Acute Care Surgery,Tucson, AZ, USA
Introduction:
Traumatic carotid artery dissection (CAD) is a rare and potentially disastrous injury. Because of the infrequent occurrence of this injury, the incidence data have not been available. The aim of our study was to analyze the trends of CAD and survival in the past 5 years.
Methods:
Five-year (2010-2014) analysis of all trauma patients diagnosed with CAD in the TQIP. Outcome measures were prevalence and mortality after CAD in past 5 years. Regression analysis was performed to control for demographics, vital and injury parameters.
Results:
808194 trauma patients were analyzed. 51 patients were diagnosed with CAD. Mean age 43±17 years, 76.4% (39/51) were males, and 68.6% (37/51) whites. Mechanism of Injury (MOI) was blunt in 98%(50/51). Overall mortality rate was 13.7% (7/51). Head injuries (73%, n=26/51) was most commonly associated with CAD followed by face (57%, n=29/51) and cervical spine injuries (43%, n=20/51). 19.6% (10/51) of the patients had a cerebrovascular accident. All of the patients were admitted to ICU and received mechanical ventilation. Prevalence of CAD decreased during the 5-years study period while mortality rate increased (Fig1). On regression analysis presence of combined head, C-spine and facial injuries were an independent predictor of CAD (OR 1.3, [1.05-4.53], p=0.04).
Conclusion:
Carotid artery dissection following trauma is a rare injury, detected in about 6.3/100,000 trauma patients. Combination of cervical, head and face injuries increases the risk of carotid artery dissection. Patients with combined head, facial and cervical injuries should undergo CTA for early detection of carotid artery dissection and may help to improve outcomes.
