Epidemiology of vascular injury in trauma-ICU patients over a decade – the KZN experience

Abstract

Background: Vascular injuries are among the causes of preventable death and disabilities. Vascular injuries are observed in both the civilian and combat setting. The vessel injured and mechanism of injury are important considerations prior to the management.

Methods: This was a combined retrospective and prospective study from January 2013 until December 2022 and included patients with vascular trauma requiring trauma-ICU admission. Frequencies and percentages were calculated to summarise categorical data. Median, quartiles and range were calculated to summarise numerical data. Ethical clearance was granted by the University of KwaZulu-Natal BREC (BREC 0004353/2022) and the Department of Health.

Results: A total of 2 805 trauma patients were treated by the author’s institution over a period of 10 years. From this number, there were 153 (5.5%) patients with vascular injuries who met the criteria to be enrolled in the study. The most commonly injured vessel was the CCA, with a total of 26 (13.5%) and the most common associated injury was bone fractures with a total number of 66 (53.2%). Penetrating trauma accounted for 99 (64.7%) of the cases, which is significantly higher than the blunt trauma component of 54 (35.2%) cases. Of the penetrating injuries 51 (33%) were due to stab wounds, 46 (30%) were due to gunshots, one (0.6%) was due to a bush knife and one (0.6%) due to a bicycle spoke accident.

Conclusion: This study makes an important contribution to the literature because it focuses on the epidemiology of vascular injury only in a subset of patients that are in ICU, whereas most studies focus on all patients. In order to prevent these injuries and associated injuries, the Department of Health with other government departments needs to develop practical and effective preventive measures.