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Penetrating Vascular Injuries of the Lower Limbs after Stab Wounds: Predictive Factors of Limb Loss and Mortality

Background: Penetrating vascular injuries (PVIs) of the lower limbs due to stab wounds are associated with high mortality and limb loss rates. We analyzed the outcomes of a series of patients who underwent surgical treatment of these lesions, assessing the presence of any factor associated with limb...

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Autores principales: Derbel, Bilel, Mazzaccaro, Daniela, Krarti, Nidhal, Miri, Rim, Khadhar, Yassine, Ben Mrad, Melek, Righini, Paolo, Nano, Giovanni, Denguir, Raouf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219138/
https://www.ncbi.nlm.nih.gov/pubmed/37240581
http://dx.doi.org/10.3390/jcm12103476
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author Derbel, Bilel
Mazzaccaro, Daniela
Krarti, Nidhal
Miri, Rim
Khadhar, Yassine
Ben Mrad, Melek
Righini, Paolo
Nano, Giovanni
Denguir, Raouf
author_facet Derbel, Bilel
Mazzaccaro, Daniela
Krarti, Nidhal
Miri, Rim
Khadhar, Yassine
Ben Mrad, Melek
Righini, Paolo
Nano, Giovanni
Denguir, Raouf
author_sort Derbel, Bilel
collection PubMed
description Background: Penetrating vascular injuries (PVIs) of the lower limbs due to stab wounds are associated with high mortality and limb loss rates. We analyzed the outcomes of a series of patients who underwent surgical treatment of these lesions, assessing the presence of any factor associated with limb loss and mortality; (2) Methods: Data of patients admitted from 01/2008 to 12/2018 were retrospectively analyzed. Primary outcomes were the limb loss and the mortality rate at 30 days postoperatively. Univariate and multivariate analyses were performed as appropriate. p values < 0.05 were considered significant; (3) Results: Data of 67 male patients were analyzed. Two died (3%) and three (4.5%) had a lower limb amputation after failed revascularization. In the univariate analysis, the clinical presentation significantly affected the risk of postoperative mortality and limb loss. The location of the lesion at the superficial femoral artery (OR 4.32, p = 0.001) or at the popliteal artery (OR 4.89, p = 0.0015) also increased the risk. In the multivariate analysis, the need for a vein graft bypass was the only significant predictor of limb loss and mortality (OR 4.58, p < 0.0001); (4) Conclusions: PVIs of lower limbs due to stab wounds were lethal in 3% of cases and lead to a secondary major amputation in 4.5% more cases. The need for a vein bypass grafting was the strongest predictor of postoperative limb loss and mortality.
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spelling pubmed-102191382023-05-27 Penetrating Vascular Injuries of the Lower Limbs after Stab Wounds: Predictive Factors of Limb Loss and Mortality Derbel, Bilel Mazzaccaro, Daniela Krarti, Nidhal Miri, Rim Khadhar, Yassine Ben Mrad, Melek Righini, Paolo Nano, Giovanni Denguir, Raouf J Clin Med Article Background: Penetrating vascular injuries (PVIs) of the lower limbs due to stab wounds are associated with high mortality and limb loss rates. We analyzed the outcomes of a series of patients who underwent surgical treatment of these lesions, assessing the presence of any factor associated with limb loss and mortality; (2) Methods: Data of patients admitted from 01/2008 to 12/2018 were retrospectively analyzed. Primary outcomes were the limb loss and the mortality rate at 30 days postoperatively. Univariate and multivariate analyses were performed as appropriate. p values < 0.05 were considered significant; (3) Results: Data of 67 male patients were analyzed. Two died (3%) and three (4.5%) had a lower limb amputation after failed revascularization. In the univariate analysis, the clinical presentation significantly affected the risk of postoperative mortality and limb loss. The location of the lesion at the superficial femoral artery (OR 4.32, p = 0.001) or at the popliteal artery (OR 4.89, p = 0.0015) also increased the risk. In the multivariate analysis, the need for a vein graft bypass was the only significant predictor of limb loss and mortality (OR 4.58, p < 0.0001); (4) Conclusions: PVIs of lower limbs due to stab wounds were lethal in 3% of cases and lead to a secondary major amputation in 4.5% more cases. The need for a vein bypass grafting was the strongest predictor of postoperative limb loss and mortality. MDPI 2023-05-15 /pmc/articles/PMC10219138/ /pubmed/37240581 http://dx.doi.org/10.3390/jcm12103476 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Derbel, Bilel
Mazzaccaro, Daniela
Krarti, Nidhal
Miri, Rim
Khadhar, Yassine
Ben Mrad, Melek
Righini, Paolo
Nano, Giovanni
Denguir, Raouf
Penetrating Vascular Injuries of the Lower Limbs after Stab Wounds: Predictive Factors of Limb Loss and Mortality
title Penetrating Vascular Injuries of the Lower Limbs after Stab Wounds: Predictive Factors of Limb Loss and Mortality
title_full Penetrating Vascular Injuries of the Lower Limbs after Stab Wounds: Predictive Factors of Limb Loss and Mortality
title_fullStr Penetrating Vascular Injuries of the Lower Limbs after Stab Wounds: Predictive Factors of Limb Loss and Mortality
title_full_unstemmed Penetrating Vascular Injuries of the Lower Limbs after Stab Wounds: Predictive Factors of Limb Loss and Mortality
title_short Penetrating Vascular Injuries of the Lower Limbs after Stab Wounds: Predictive Factors of Limb Loss and Mortality
title_sort penetrating vascular injuries of the lower limbs after stab wounds: predictive factors of limb loss and mortality
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219138/
https://www.ncbi.nlm.nih.gov/pubmed/37240581
http://dx.doi.org/10.3390/jcm12103476
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