Physical diagnostics of arterial trauma in patients of various ages

Abstract

Aim. To evaluate the effectiveness of physical methods for diagnosing arterial trauma (AT) in patients of various ages. Materials and methods. The hospital medical records data of 222 patients with AT of various ages who were on treatment in the Vascular Surgery Department of Lviv Regional Clinical Hospital in 1992–2019 were analyzed. The patients were divided into seven groups: infants (≤2 years, 4.05 %), early childhood (3–6 years, 0.9 %), childhood (7–12 years, 4.05 %), adolescents (13–18 years, 11.3 %), young adults (19–40 years, 48.6 %), adults (41–65 years, 24.8 %), elderly (≥66 years, 6.3 %). AT was determined from the hard (pulsatile bleeding, absent pulsations distal to the trauma site, expanding hematoma, thrill or bruit over the trauma site, signs of ischemia) or soft (bleeding history, weakened pulsation on an injured side, nonpulsatile hematoma, bone fracture or wound in the projection of a vessel, neurological disorders) symptoms. Physical examination results were compared with intraoperative findings (n = 202, 91 %) or comprehensive instrumental examination. Results. Patients of all ages with AT had a combination of hard and soft symptoms in 44.6–68.8 % (95 % CI) of cases, 10.3–45.0 % (95 % CI) had soft symptoms, and 5.4–23.5 % (95 % CI) had hard symptoms of AT. According to the multiple regression model, the type of AT symptoms was influenced by the mechanism of injury, rather patient's age, etiology, topography, or type of pathomorphological changes in the vessels. Physical examination methods were sufficient to establish a clinical diagnosis of AT and to choose a treatment modality in 20.0–48.3 % (95 % CI) of patients of all ages. The method for diagnosing AT (physical or combination of physical with instrumental) was influenced by patient's age, year of hospitalization and mechanism of injury. Conclusions. Physical methods for diagnosing AT (hard and soft symptoms) have high diagnostic value in examining patients of all ages.

Keywords

• arterial injuries
• symptom vessel injuries
• children
• adults