This is a descriptive study using a Japanese nationwide trauma registry from 2004 through 2019. We included patients aged ≥13 years presenting to the emergency department (ED) with BCVI, defined as a blunt trauma to any of the following vessels: common/internal carotid artery, external carotid artery, vertebral artery, external jugular vein, and internal jugular vein. We delineated characteristics of each BCVI classified according to three damaged vessels (common/internal carotid artery, vertebral artery, and others). In addition, we applied network analysis to unravel patterns of co-occurring injuries among patients with BCVI by four common trauma mechanisms (car accident, motorcycle/bicycle accident, simple fall, and fall from a height).
Among 311,692 patients who visited the ED for blunt trauma, 454 (0.1%) patients had BCVI. Patients with common/internal carotid artery injuries presented to the ED with severe symptoms (e.g., the median Glasgow Coma Scale was 7) and had high in-hospital mortality (45%), while patients with vertebral artery injuries presented with relatively stable vital signs. Network analysis showed that head-vertebral-cervical spine injuries were common across four trauma mechanisms (car accident, motorcycle/bicycle accident, simple fall, and fall from a height), with co-occurring injuries of the cervical spine and vertebral artery being the most common injuries due to falls. In addition, common/internal carotid artery injuries were associated with thoracic and abdominal injuries in patients with car accidents.
Based on analyses of a nationwide trauma registry, we found that patients with BCVI had distinct patterns of co-occurring injuries by four trauma mechanisms. Our observations provide an important basis for the initial assessment of blunt trauma and could support the management of BCVI.
方法:这是一项描述性研究,使用2004年至2019年的日本全国创伤登记处。我们纳入了年龄≥13岁的急诊(ED)患者,定义为对以下任何血管的钝性创伤:颈总/颈内动脉,颈外动脉,椎动脉,颈外静脉,和颈内静脉.我们根据三个受损血管(颈总动脉/颈内动脉,椎动脉,和其他人)。此外,我们将网络分析应用于通过四种常见创伤机制(车祸,摩托车/自行车事故,简单的秋天,并从高处坠落)。
结果:在311,692例因钝性外伤而就诊的患者中,454例(0.1%)患者有BCVI。患有颈总动脉/颈内动脉损伤的患者出现严重症状(例如,格拉斯哥昏迷评分中位数为7),住院死亡率很高(45%),而椎动脉损伤患者的生命体征相对稳定。网络分析显示,头-脊椎-颈椎损伤在四种创伤机制中是常见的(车祸,摩托车/自行车事故,简单的秋天,并从高处坠落),颈椎和椎动脉的共同损伤是最常见的跌倒损伤。此外,在车祸患者中,颈总动脉/颈内动脉损伤与胸部和腹部损伤相关.
结论:根据对全国创伤登记的分析,我们发现BCVI患者有4种创伤机制共同发生的不同类型的损伤.我们的观察结果为钝性创伤的初步评估提供了重要依据,并可能支持BCVI的管理。