CTA-Based Screening Reduces Time to Diagnosis and Stroke Rate in Blunt Cervical Vascular Injury

• DOI: 10.1097/ta.0b013e3181b84408
• Publication Date: 2009-09-04T07:32:19Z
• Authors: Alexander L. Eastman; Vijay Muraliraj; Jason L. Sperry; Joseph P. Minei
• Keywords: Trauma Center; Blunt trauma; Computed Tomography Angiography; Stroke; Abbreviated Injury Scale

Background: Advances in computed tomography capabilities have enabled trauma surgeons to screen for and diagnose the severity of blunt cervical vascular injury (BCVI) using tomographic angiography (CTA) alone. We hypothesized that use CTA-alone screening diagnostic methods would reduce time interval from admission diagnosis and, hence, also stroke rates associated with these injuries. Methods: All patients admitted a level I center after December 1999 at risk BCVI were screened. Until March 2005, screened catheter (CA). Subsequently, screening/diagnostic program was initiated simultaneously standardized interdisciplinary treatment guidelines BCVI. Data controls subsequently obtained by reviewing registry records. Results: Of 3012 service admissions April 2005 July 2006, 26 found diagnosed CTA A standardized, grade-based set then immediately based on findings. Time rate compared 79 during CA-based screening. There no differences sex, mean age, Injury Severity Score, head/neck Abbreviated Scale, or arrival Glasgow Coma Scale between CA groups. With screening, ± SD 31.2 41.1 hours. After transition this reduced 2.65 3.3 hours (p < 0.001). During era overall our institution 15.2% (n = 12 79). initiation CTA-based 3.8% 1 26, p 0.046). Conclusions: The program, along guidelines, 12-fold institutional due fourfold. This may be earlier definitive therapy.