OBJECTIVE: To investigate the impact of associated extra-abdominal injury on morbidity and mortality in poly-traumatized patients with blunt abdominal trauma. METHODS: This analysis included poly-traumatized patients with blunt abdominal trauma treated at the Emergency Unit of Minia University Hospital and Misr University for Science and Technology Hospital, Minia, Egypt, between March 2006 and March 2008. This study included patients aged 4-73 years with injury severity score (ISS) more than 18 and indicated for surgical intervention. Data were analyzed with details of injury, treatment, complications, and mortality. RESULTS: Inclusion criteria were met by 94 patients with mean ISS of 29.3 6.4. Most frequent injuries were seen in the spleen (61.7%) and liver (47.9%). Chest trauma represents most common extra-abdominal trauma (67%). Thirty-six patients (38.3%) died during their hospital stay. Most frequent reasons for death were hemorrhagic shock (27.8%), acute respiratory distress syndrome (27.8%), and head trauma (22.2%). There was a positive relationship between liver injury and mortality, which was not found in splenic injuries. Significantly more deaths were attributed to primarily extra-abdominal injuries (66.7%) and then to intra-abdominal injuries (19.4%). In 5 patients (13.9%), a combination of intra- and extra- abdominal injuries caused post-traumatic death. CONCLUSION: Extra-abdominal injuries add to the morbidity and mortality from blunt abdominal trauma in poly-traumatized patients. Routine computerized tomography scanning can minimize negative abdominal exploration and facilitate better management of extra-abdominal injuries.
OBJECTIVE: To investigate the impact of associated extra-abdominal injury on morbidity and mortality in poly-traumatized patients with blunt abdominal trauma. METHODS: This analysis included poly-traumatized patients with blunt abdominal trauma treated at the Emergency Unit of Minia University Hospital and Misr University for Science and Technology Hospital, Minia, Egypt, between March 2006 and March 2008. This study included patients aged 4-73 years with injury severity score (ISS) more than 18 and indicated for surgical intervention. Data were analyzed with details of injury, treatment, complications, and mortality. RESULTS: Inclusion criteria were met by 94 patients with mean ISS of 29.3 6.4. Most frequent injuries were seen in the spleen (61.7%) and liver (47.9%). Chest trauma represents most common extra-abdominal trauma (67%). Thirty-six patients (38.3%) died during their hospital stay. Most frequent reasons for death were hemorrhagic shock (27.8%), acute respiratory distress syndrome (27.8%), and head trauma (22.2%). There was a positive relationship between liver injury and mortality, which was not found in splenic injuries. Significantly more deaths were attributed to primarily extra-abdominal injuries (66.7%) and then to intra-abdominal injuries (19.4%). In 5 patients (13.9%), a combination of intra- and extra- abdominal injuries caused post-traumatic death. CONCLUSION:Extra-abdominal injuries add to the morbidity and mortality from blunt abdominal trauma in poly-traumatized patients. Routine computerized tomography scanning can minimize negative abdominal exploration and facilitate better management of extra-abdominal injuries.
Authors: Federico Coccolini; Giulia Montori; Fausto Catena; Yoram Kluger; Walter Biffl; Ernest E Moore; Viktor Reva; Camilla Bing; Miklosh Bala; Paola Fugazzola; Hany Bahouth; Ingo Marzi; George Velmahos; Rao Ivatury; Kjetil Soreide; Tal Horer; Richard Ten Broek; Bruno M Pereira; Gustavo P Fraga; Kenji Inaba; Joseph Kashuk; Neil Parry; Peter T Masiakos; Konstantinos S Mylonas; Andrew Kirkpatrick; Fikri Abu-Zidan; Carlos Augusto Gomes; Simone Vasilij Benatti; Noel Naidoo; Francesco Salvetti; Stefano Maccatrozzo; Vanni Agnoletti; Emiliano Gamberini; Leonardo Solaini; Antonio Costanzo; Andrea Celotti; Matteo Tomasoni; Vladimir Khokha; Catherine Arvieux; Lena Napolitano; Lauri Handolin; Michele Pisano; Stefano Magnone; David A Spain; Marc de Moya; Kimberly A Davis; Nicola De Angelis; Ari Leppaniemi; Paula Ferrada; Rifat Latifi; David Costa Navarro; Yashuiro Otomo; Raul Coimbra; Ronald V Maier; Frederick Moore; Sandro Rizoli; Boris Sakakushev; Joseph M Galante; Osvaldo Chiara; Stefania Cimbanassi; Alain Chichom Mefire; Dieter Weber; Marco Ceresoli; Andrew B Peitzman; Liban Wehlie; Massimo Sartelli; Salomone Di Saverio; Luca Ansaloni Journal: World J Emerg Surg Date: 2017-08-18 Impact factor: 5.469