The American surgeon
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The records of 67 patients with inferior vena cava (IVC) injuries seen from 1980-1986 were reviewed. The mortality rate (MR) overall was 57 per cent, and for specific portions of the IVC it was: retrohepatic - 60 per cent (9/15); suprarenal 59 per cent (16/27); pararenal - 45 per cent (5/11); and infrarenal - 57 per cent (8/14). Several prognostic factors were identified. ⋯ Of 18 patients who received more than ten units of blood and survived the surgery, ten (56%) developed septic complications, and four of these patients died. Of 17 patients who received less than ten units of blood and survived the surgery, none became septic. Thus, early control of shock and bleeding is essential, not only to reduce mortality rate, but also later septic complications.