Vascular trauma in England, Wales and Ireland: an analysis of the Trauma Audit and Research Network national data registry
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Objective
To define and characterise the epidemiology, management, and outcomes of vascular trauma in the UK and Ireland following the introduction of a national major trauma network.
Methods
A retrospective observational study of The Trauma Audit and Research Network registry. Patients with traumatic vascular injury between 2013 and 2020 were analysed (n = 8 357). Demographics, injury descriptors, severity score, patient management, and outcomes were analysed.
Results
The case volume increased 40.2% between 2013 (n = 780) and 2020 (n = 1 094). The median patient age was 40.6 years, and over two thirds (n = 5 758) of injuries occurred following blunt trauma. Over half of the patients were admitted in haemorrhagic shock, two thirds presenting outside normal working hours (17:00 – 08:00). From nearly 9 000 vessel injuries, 7 136 (80.6%) were arterial; the aorta was the most frequently involved vessel (n = 1 115). Interventions were carried out in 3 338 (39.9%) patients, 2 639 (73.8%) via open surgery, with a median time to theatre of 3.3 hours. Interventional radiology procedures included 616 embolisations and 319 primary stentings. The aorta was the most common site for intervention outside the extremities, 250 (88.3%) of which were stented. Overall and early mortality rates fell significantly during the study from 15.9% and 8.1% in 2013 to 11.1% and 2.9% in 2020 (r = –0.82, r = –0.90, p = .006, p = .001), respectively. Median critical care length of stay was five days, and overall hospital stay for all patients was 12 days.
Conclusion
Following the transition towards major trauma networks, overall and early vascular trauma mortality reduced significantly. Co-operative development of national vascular and trauma registries to capture data relevant to quality improvement activity is needed to inform and shape future practice.
To define and characterise the epidemiology, management, and outcomes of vascular trauma in the UK and Ireland following the introduction of a national major trauma network.
Methods
A retrospective observational study of The Trauma Audit and Research Network registry. Patients with traumatic vascular injury between 2013 and 2020 were analysed (n = 8 357). Demographics, injury descriptors, severity score, patient management, and outcomes were analysed.
Results
The case volume increased 40.2% between 2013 (n = 780) and 2020 (n = 1 094). The median patient age was 40.6 years, and over two thirds (n = 5 758) of injuries occurred following blunt trauma. Over half of the patients were admitted in haemorrhagic shock, two thirds presenting outside normal working hours (17:00 – 08:00). From nearly 9 000 vessel injuries, 7 136 (80.6%) were arterial; the aorta was the most frequently involved vessel (n = 1 115). Interventions were carried out in 3 338 (39.9%) patients, 2 639 (73.8%) via open surgery, with a median time to theatre of 3.3 hours. Interventional radiology procedures included 616 embolisations and 319 primary stentings. The aorta was the most common site for intervention outside the extremities, 250 (88.3%) of which were stented. Overall and early mortality rates fell significantly during the study from 15.9% and 8.1% in 2013 to 11.1% and 2.9% in 2020 (r = –0.82, r = –0.90, p = .006, p = .001), respectively. Median critical care length of stay was five days, and overall hospital stay for all patients was 12 days.
Conclusion
Following the transition towards major trauma networks, overall and early vascular trauma mortality reduced significantly. Co-operative development of national vascular and trauma registries to capture data relevant to quality improvement activity is needed to inform and shape future practice.
Date Issued
2025-02-07
Date Acceptance
2025-02-03
Citation
European Journal of Vascular and Endovascular Surgery, 2025
ISSN
1078-5884
Publisher
Elsevier
Start Page
S1078-5884(25)00121-2
Journal / Book Title
European Journal of Vascular and Endovascular Surgery
Copyright Statement
Copyright: © 2025 European Society for Vascular Surgery. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies. This is the author’s accepted manuscript made available under a CC-BY licence in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy)
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39929315
PII: S1078-5884(25)00121-2
Subjects
Epidemiology
Incidence
Outcomes
Trauma
UK
Publication Status
Published online
Coverage Spatial
England
Date Publish Online
2025-02-07