ILIAC VESSEL INJURY - OPERATIVE PHYSIOLOGY RELATED TO OUTCOME

Background: Fifty-three patients treated at a level I trauma center wi th iliac vessel injury were studied to determine if body temperature a nd acid-base status in the operating room predicts outcome. Methods: R ecords were reviewed for demographics, mechanism of injury, body tempe rature, acid-base status, operative management, and outcome. Statistic al methods included Student's t test, odds ratio determination, and ch i-square analysis to determine statistical significance. Results: Fift y-three patients (47 male, 6 female) sustained 92 iliac vascular injur ies (36 arterial, 56 venous). Mortality was 34%, with 72% of deaths du e to shock within 24 hours. Physiologic parameters differed significan tly between survivors and nonsurvivors. Odds ratio identified six cond itions; the number present predicted outcome. Conclusions: (1) There a re significant differences between initial and final operating room te mperature and acid-base status in survivors versus nonsurvivors with i liac vessel injury. Conditions for adds ratio can be calculated and co rrelated with outcome, (2) A patient with two or more conditions shoul d be considered for an abbreviated laparotomy to allow for reversal of ''physiologic failure.''