Blunt vascular neck injuries: Diagnosis and outcomes of extracranial vessel injury

Background: Blunt vascular neck injuries (BVNIs) are rare, often occult, and potentially devastating injuries. The purpose of this study was to identify a high-risk group, which would benefit from screening. Methods: Patients with BVNIs were identified from our trauma registry and charts were reviewed. Potential risk factors for BVNI were evaluated by univariate and multivariate logistic regression. Results: Thirty-one BVNIs were identified in 22 patients. The stroke rate was 60% and the mortality rate was 25%. Univariate analysis showed Glasgow Coma Scale score :5 8, head injury (Abbreviated Injury Scale [AIS] score greater than or equal to 3), basal skull fracture, facial injury, other neck injury, thorax injury (AIS score greater than or equal to 3), abdominal injury, and cervical spine injury to be significant (p < 0.05). The multivariate predictive model had two predictors remaining significant: thorax injury (AIS [thorax] score greater than or equal to 3) and Glasgow Coma Scale score less than or equal to 8. Conclusion: Screening should be undertaken for patients at increased risk for BVNI: those with risk factors identified in our regression analysis and factors previously reported.