Aim: To report the long-term clinical and radiological outcomes of patients discharged with BCVI.
Methods: Retrospective cohort study of BCVI patients presenting January 2014 to June 2021, identified by the Alfred trauma registry. Data on follow-up imaging, antithrombotic details and clinical outcome including recurrent strokes were collected.
Results: Of 300 patients in the cohort, 118 patients (39%) with 139 BCVIs have been followed up for median time of 15 months. 17% of the injuries were Biffl grade 1, 41% were grade 2, 7% were grade 3 and 35% were grade 4. By 6 months, 78% of Biffl Low grade injuries (grades 1 and 2) resolved or improved on follow up CTA, while 72% of high grades (grade 3 & grade 4) remained unchanged. 60% of the patients were on aspirin temporarily for an average duration of 9.3 months. There were no stroke in the 118 patients with available follow up data, although 7 patients (6%) had acute ischemic stroke soon after BCVI during admission.
Conclusion: Our results are limited by low rates of complete follow up in complex trauma patients but most Biffl low grade BCVIs remodelled within 6 months, whilst most high grade BCVIs persisted on follow up. No strokes occurred after discharge. These data are an addition to BCVI literature and should be reassuring to BCVI patients. The need for BCVI follow up imaging by grade and optimal duration of antithrombotic treatment remains uncertain and warrants further investigation, potentially in large multicentre trauma registries.