BACKGROUND: The role of @entity954 ( @entity954 ) during surgical repair of major @entity1317 is controversial. Any potential improvement in arterial patency must be weighed against the risk of @entity548 in these critically injured @entity1 . We hypothesized that @entity954 would increase arterial patency without increasing @entity548 complications. METHODS: We conducted a multi-institution, retrospective cohort study of @entity130 @entity1 with major @entity1317 from 2005-2013 in 3 level I centers. @entity1317 of the neck, torso and proximal extremities requiring operative management were included. Our primary endpoint was maintenance of arterial patency during index hospitalization. Complications related to @entity548 were assessed. The association between @entity954 and arterial patency was evaluated using Chi-Square, t-test and multiple logistic regression modeling. RESULTS: Of 323 study @entity1 , most were male (88%) and injured by gunshot wounds (69%). @entity1 repaired with @entity954 (n=154) were compared to those repaired without @entity954 (n=169). No difference in age, gender, mechanism, admission heart rate, or concomitant injury was detected between the groups (all p>0.05). @entity954 use was associated with greater arterial patency rates (93% vs. 85%, p=0.02) without increasing return to OR for @entity548 (4% vs. 6%, p=0.29). After controlling for gender, admission hemodynamics, ISS, injury location and postoperative anticoagulation, multivariable regression determined @entity954 @entity1 were 2.6 times more likely (OR 2.6, 95%CI 1.1-6.2, p=0.03) to maintain patency. @entity1 who maintained arterial patency were then less likely to return to the OR (9% vs. 78%, p<0.001) with shorter ICU (median 3 vs. 9 days, p<0.01) and hospital LOS (median 13 vs. 21 days, p<0.01). CONCLUSION: @entity1 who underwent operative repair of @entity1317 utilizing @entity954 experienced better arterial patency without additional @entity548 complications as compared to those repaired without @entity954 . Our data suggests that @entity954 may improve arterial patency rates after repair and the attributable @entity548 risk of @entity954 may be overstated. LEVEL OF EVIDENCE: Therapeutic/Care Management, Level III.

Systemic intraoperative anticoagulation during XXXX repair: Implications for patency and @entity548 .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhage', 'bleeding'] @entity954 :: ('MESH:D016063', 'Disease') :: ['SIAC', 'systemic intraoperative anticoagulation'] @entity1317 :: ('MESH:D057772', 'Disease') :: ['vascular injury', 'Arterial injuries', 'arterial injuries'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity1317 :: (MESH:D057772,Disease) :: ['arterial injury']
