December 12, 2008

Quality of Life of Trauma Patients with Vascular Injuries Requiring Revascularization

Eileen DeGrandis, BS, John Blebea, MD, John Wang, Patrick Kelly, RVT, Eugene Palchik, MD.
Temple University, Philadelphia, PA, USA.

Quality of Life of Trauma Patients with Vascular Injuries Requiring Revascularization
Background: Trauma patients with extremity vascular injuries serious enough to require revascularization have significant morbidity and mortality. There is little published information on the contribution of the vascular injuries to the subsequent quality of life in such patients.
Methods: The SF-36 questionnaire, which measures quality of life based on both mental and physical functioning was administered to patients who had sustained vascular trauma requiring revascularization. A comparison group of trauma patients during the same time period but without vascular injuries was also queried. Duplex ultrasound studies were analyzed for bypass graft patency and distal perfusion.
Results: During the study period between 2005-2008, a total 45 patients required major vascular repair following traumatic extremity injury. Mechanisms of injury included gunshot wounds (76%), motor vehicle accidents (9%), falls (4%), and other penetrating injuries (stab wounds/glass 11%). Fourteen of these patients completed the SF-36 questionnaire and were compared to ten non-vascular trauma controls. The median age of both groups was 23 years. In the revascularization group, 79% underwent bypass with a reserved saphenous vein, 7% received a synthetic graft and 14% had primary vessel repair. At a mean follow-up of 21 months, although the overall SF-36 scores were similar between the two groups [58 + 5 vs 60 + 8; revascularization vs controls; p=0.84] the revascularization patients had a significantly lower composite physical as compared to mental health score [52 + 5 vs 65 + 6; p < 0.05]. There was no such difference in the non-vascular trauma patients. Subgroup analyses between the two patient cohorts did not identify statistically significant differences between them although there was a trend toward lessor physical functioning in the vascular injury group [29 + 10 vs 58 + 12; p=0.08].
Conclusions: Trauma patients who have vascular injuries requiring arterial repair have significantly decreased long-term physical health outcomes as compared to trauma patients without vascular involvement. Their emotional and mental quality of life, however, are not negatively affected.

Back to Annual Meeting
Back to Program