A 9-year retrospective study of vascular trauma at a suburban level I trauma center: patterns, predictors, and outcomes

Purpose: The objective of this study was to describe the epidemiology, mechanisms of injury, and outcomes of vascular trauma patients admitted to an American College of Surgeons level I trauma center located in a predominantly suburban county on Long Island, New York, United States, and to compare these findings with the existing literature. Methods: This retrospective observational study used data collected from the hospital's trauma registry for all patients with documented vascular trauma between January 2015 and December 2023, identified through relevant ICD-9 and ICD-10 codes. Results: The trauma registry query identified 208 vascular trauma cases out of 12,617 total trauma cases (1.7%). The overall mortality rate was 19.7%, and the amputation rate was 2.4%. Patients were predominantly male, with a mean age of 40 years. Black and Hispanic patients were disproportionately affected. Most injuries were blunt, and these were associated with higher Injury Severity Scores (ISS), lower Glasgow Coma Scale (GCS) scores, and longer hospital length of stay (LOS). Multivariate analysis demonstrated a significant overall effect of mechanism of injury (blunt vs. penetrating) on ISS, GCS, and hospital LOS. Truncal injuries carried higher mortality than face/neck and extremity injuries. Conclusions: Although relatively uncommon, vascular trauma remains associated with significant morbidity and mortality, particularly in blunt mechanisms and truncal injuries. The findings highlight the importance of regional epidemiological surveillance and raise concerns about racial disparities. These results emphasize the need for targeted prevention efforts, improved resource allocation, and further research to address the social and clinical factors underlying poor outcomes in vascular trauma.