Vascular surgeons provide significant value as intraoperative consultants for trauma centers, according to a new analysis published in the Journal of Vascular Surgery. In fact, one facility saw vascular surgeon consultations increase by more than 500% over the course of 15 years.
“Few studies have evaluated the role of the vascular surgeon in the management of the trauma patient, and none have looked exclusively at intraoperative vascular consultations in the trauma population,” wrote first author Jake F. Hemingway, MD, of the University of Washington in Seattle, and colleagues. “In addition, no studies have attempted to characterize the changing trends in intraoperative vascular consultation over time. It is unclear what role, if any, vascular surgeons play in the management of intraoperative vascular emergencies in trauma.”
Hemingway et al. tracked data on patients treated at a single level I trauma center from 2002 to 2017. The team focused on 234 procedures that included a vascular surgeon who was not listed as the patient’s primary surgeon provided a consulting service. The trauma patients included in the analysis tended to be young and presented with low rates of hypertension, diabetes and peripheral artery disease.
Overall, the team found, the number of procedures that required an intraoperative response from a vascular surgeon increased by 529% from 2002 to 2017. The most common reasons for consultation were extremity malperfusion (37%), uncontrollable hemorrhage (26%) and arterial injury (20%). While 45% of the procedures involved the patient’s lower extremities, 17% involved their upper extremities, 15% involved their head and neck, 14% involved their inferior vena cava and iliac veins and 9% involved their aorta.
“In the management of the trauma patient at our level I trauma center, vascular surgeons are increasingly being called on as intraoperative consultants to assist with a variety of issues, including ischemia, uncontrolled hemorrhage, and difficult exposures,” the authors wrote. “Vascular surgeons provide effective and efficient care, with low mean operative times and high rates of revascularization and hemorrhage control.”
The team also said that this ongoing trend, as well as its “financial implications,” are something the industry needs to recognize.
“As vascular surgeons become increasingly essential team members at a level I trauma center, one may argue that the 24-hour in-house availability of vascular surgeons at a level I trauma center should be mandated, similar to other required specialties such as plastic surgery and oral and maxillofacial surgery,” they wrote.
Click here for the group’s full analysis.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.