DOI: 10.38053/acmj.1998148 ISSN: 2718-0115

Diagnostic yield of computed tomography angiography in traumatic extremity vascular injuries and clinical and laboratory predictors: a retrospective cohort study

Burcu Özen Karabulut, Ali Ekber Karabulut, Cem Yıldırım, Ahmet Aykut
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Aims: This study aimed to evaluate the diagnostic yield of computed tomography angiography (CTA) in emergency department (ED) patients with suspected traumatic extremity vascular injury, and to identify clinical and laboratory predictors of CTA positivity and hospital admission. Methods: This single-center, retrospective, observational cohort study included 201 consecutive ED presentations undergoing extremity CTA between January 1, 2022, and December 31, 2024. The primary outcome was CTA positivity, defined as detection of any pathological finding consistent with traumatic vascular injury; the secondary outcome was hospital admission. Candidate predictors included age, gender, injury mechanism, anatomical involvement, and first-draw ED laboratory values [glucose, WBC count, hemoglobin, hematocrit, neutrophil-to-lymphocyte ratio (NLR)]. Two multivariable logistic regression models were constructed for each outcome; performance was assessed via AUROC.Results: Of 201 patients (94.0% male; median age 28 years), 35 (17.4%) had CTA-positive findings. On univariable analysis, hematocrit (p=0.009), hemoglobin (p=0.031), and NLR (p=0.004) differed significantly between groups. On multivariable analysis, hematocrit was the sole independent predictor of CTA positivity (aOR 0.932; 95% CI 0.871-0.998; p=0.044; AUROC 0.711). Seventy patients (34.8%) were admitted; CTA positivity (aOR 5.094; p

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