Rashid Usman, Muhammad Jamil, Saira Ambreen, Raoon Khan, Shahid Majeed.
Management of Traumatic Abdominal Inferior Vena Cava Injuries and Predictors of its Mortality.
J Surg Pak Jan ;24(3):110-5.

Objective: To document the experience of management of traumatic abdominal inferior vena cava (IVC) injuries and the impact of various perioperative variables on its mortality. Study design: Cross sectional study. Place & Duration of study: Military Trauma Centres, Combined Military Hospital Quetta, Lahore, Peshawar and Rawalpindi, from January 2005 to January 2019. Methodology: All consecutive patients with IVC injuries fulfilling the inclusion criteria, were included. Demographics, management and perioperative variables were recorded. Results: Out of 42 patients with mean age 26.8 +- 3.3 year, there were 32 (76.2%) males. Penetrating injury was the cause in 28 (66.7%) patients. Most common injury site was infra renal segment (76.2%). Commonest type of injury was partial laceration (n=12 - 28.5%) and most common repair performed was primary venorrhaphy in 14 (38.9%) cases followed by ligation in 10 (27.8%). Overall mortality rate was 42.8% (n=18). In terms of repair; the mortality rate was highest for ligation (60%), me_chanism of injury [OR 1.11 (95% CI: 1.03-1.38), P = 0.002], systolic BP [OR 1.11 (95% CI: 1.02-1.33), P = 0.002], high serum lactate levels [OR 1.29 (95% CI: 1.09-1.44), P = 0.002], concomitant solid organ injury [OR 1.05 (95% CI: 1.01-1.35), P = 0.002], concomitant extra abdominal injuries, PRCT [OR 1.21 (95% CI: 1.11-1.67), P = 0.037] and prolonged ICU stay [OR 1.09 (95% CI: 1.02-1.44), P= 0.003]; were found to be independent positive predictors of higher mortality. Conclusions: Abdominal IVC injury is associated with high mortality with supra hepatic injuries being almost fatal. Best results are achieved with primary repair and ligation has poor outcome.

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