From the Research
The mortality rate for inferior vena cava (IVC) injuries is approximately 21-79%, with the most recent and highest quality study suggesting a mortality rate of 21%. This high mortality rate is primarily due to the IVC's large diameter, thin walls, and high blood flow, which can lead to rapid exsanguination when injured. Mortality varies based on the location of the injury, with retrohepatic and suprahepatic IVC injuries having higher mortality rates, while infrarenal injuries have somewhat lower mortality rates 1. The mechanism of injury also impacts survival, with penetrating trauma (such as gunshot wounds) generally having worse outcomes than blunt trauma. Patient factors that influence mortality include the presence of shock upon arrival, associated injuries to other organs, and the time elapsed between injury and definitive surgical intervention 2. Rapid transport to a trauma center, immediate resuscitation with blood products, and prompt surgical intervention with techniques such as direct repair, patch repair, or shunting are critical to improving survival chances for patients with IVC injuries 3.
Some key factors that influence mortality rates include:
- Location of the injury: retrohepatic, suprahepatic, suprarenal, pararenal, and infrarenal injuries have different mortality rates 4, 2
- Mechanism of injury: penetrating trauma (such as gunshot wounds) generally having worse outcomes than blunt trauma 2
- Presence of shock upon arrival: patients in shock have higher mortality rates 4, 2
- Associated injuries to other organs: patients with multiple injuries have higher mortality rates 2
- Time elapsed between injury and definitive surgical intervention: prompt surgical intervention improves survival chances 1, 3
Overall, the management of IVC injuries requires a multidisciplinary approach, with emphasis on prompt recognition, rapid transport to a trauma center, and immediate resuscitation and surgical intervention 1, 3.