CORRELATION BETWEEN KIDNEY AND LIVER IMPAIRMENT WITH OUTCOME IN LIMB VASCULAR TRAUMA

Abstract

Vascular trauma represents one of the most challenging surgical emergencies. The management starts in the prehospital phase and is completed by the intervention of the vascular surgeon. Vascular trauma has a high mortality and morbidity rate, depending on the type of mechanism, localization and associated lesions and it is frequently associated with long term complications. Material and methods: This paper includes 146 consecutive patients with limb trauma admitted to the Department of Vascular Surgery of the “Sf. Spiridon” County Clinical Emergency Hospital, between 2011 and 2022. From the total number, 79.59% were male patients, 73.28% from rural area, mean age 45 years old. Results: The most frequent trauma involved the upper limb with 93 cases (brachial artery - 51 cases, axillary artery - 23 cases), followed by lower limb with 54 cases. Thirty-four cases had vascular lesions involving the nerves and 47 cases were associated with venous lesions. The most frequent mechanism was penetrating lesions via stabbing or cutting (59.59%). Intra operatively, the following procedures were performed: simple exploration and hemostasis, end-to-end anastomosis, interpositions, and bypass. Seventeen patients required amputation, and 10 had decompression fasciotomies. Conclusions: The prolonged time of ischemia (> 6 hours), hemorrhagic shock, reperfusion syndrome with renal or hepatic impairment are highly correlated with an increased risk of amputation and mortality.