Samir H Haddad1, Zeyad M Yousef2, Saleh S Al-Azzam3, Abdulaziz S AlDawood4, Ali A Al-Zahrani5, Heythem A AlZamel6, Hani M Tamim7, Ahmad M Deeb8, Yaseen M Arabi9. 1. Surgical Intensive Care Unit, Intensive Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: haddads55@yahoo.com. 2. Department of Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: yousefz@ngha.med.sa. 3. Department of Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: azzams1@ngha.med.sa. 4. Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: aldawooda@hotmail.com. 5. Department of Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: zahraniaa@ngha.med.sa. 6. Department of Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: zamelh@ngha.med.sa. 7. King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, Riyadh, Saudi Arabia; Department of Internal Medicine, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: hani_t@hotmail.com. 8. King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: deebah@ngha.med.sa. 9. Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences, Respiratory Services, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: yaseenarabi@yahoo.com.
Abstract
INTRODUCTION: The Kingdom of Saudi Arabia (KSA) is one of countries with the world's highest number of deaths per 100,000 populations from road traffic accidents (RTAs). Numerous trauma victims sustain abdomino-pelvic injuries, which are associated with considerable morbidity and mortality. The purpose of this study was to describe profile, outcomes and predictors of mortality of patients with abdomino-pelvic trauma admitted to the intensive care unit (ICU) in a tertiary care trauma centre in Riyadh, KSA. METHODS: This was a retrospective analysis of prospectively collected ICU database. All consecutive patients older than 14 years with abdomino-pelvic trauma from March 1999 to June 2013 were included. The followings were extracted: demographics, injury severity, mechanism and type of injury, associated injuries, use of vasopressors and mechanical ventilation, and worst laboratory results in the first 24h. The primary outcome was hospital mortality. We compared profile and outcomes between survivors and non-survivors and reported predictors of mortality. RESULTS: Of the 11,374 trauma patients who were admitted to the hospital during the study period, 2120 (18.6%) patients had abdomino-pelvic injuries, out of which 702 (33.1%) patients were admitted to the ICU. The mean age was 30.7 (SD 14.4) years and the majority was male (89.5%). RTA was the most common cause of abdomino-pelvic trauma (70.4%). Pelvis (46.2%), liver (25.8%), and spleen (23.1%) were the most frequently injured organs; and chest (55.6%), head (41.9%), and lower extremities (27.5%) were the most commonly associated injuries. Mechanical ventilation was required in 89.6% with a mean duration of 9.1 (SD 9.2) days and emergency surgery was performed in 45.0% of the patients with prolonged ICU and hospital length of stay (10.8 [SD 10.8], 56.9 [SD 96.7] days; respectively). Of the 702 patients with abdomino-pelvic trauma, 115 (16.4%) patients did not survive. Associated head trauma and retroperitoneal haematoma, higher level of lactic acid on admission and ISS, and advanced age were potential risk factors for hospital mortality. CONCLUSIONS: Abdomino-pelvic injuries are common in trauma patients, affecting mainly young male victims, and are associated with significant morbidity and mortality, and resource utilisation.
INTRODUCTION: The Kingdom of Saudi Arabia (KSA) is one of countries with the world's highest number of deaths per 100,000 populations from road traffic accidents (RTAs). Numerous trauma victims sustain abdomino-pelvic injuries, which are associated with considerable morbidity and mortality. The purpose of this study was to describe profile, outcomes and predictors of mortality of patients with abdomino-pelvic trauma admitted to the intensive care unit (ICU) in a tertiary care trauma centre in Riyadh, KSA. METHODS: This was a retrospective analysis of prospectively collected ICU database. All consecutive patients older than 14 years with abdomino-pelvic trauma from March 1999 to June 2013 were included. The followings were extracted: demographics, injury severity, mechanism and type of injury, associated injuries, use of vasopressors and mechanical ventilation, and worst laboratory results in the first 24h. The primary outcome was hospital mortality. We compared profile and outcomes between survivors and non-survivors and reported predictors of mortality. RESULTS: Of the 11,374 traumapatients who were admitted to the hospital during the study period, 2120 (18.6%) patients had abdomino-pelvic injuries, out of which 702 (33.1%) patients were admitted to the ICU. The mean age was 30.7 (SD 14.4) years and the majority was male (89.5%). RTA was the most common cause of abdomino-pelvic trauma (70.4%). Pelvis (46.2%), liver (25.8%), and spleen (23.1%) were the most frequently injured organs; and chest (55.6%), head (41.9%), and lower extremities (27.5%) were the most commonly associated injuries. Mechanical ventilation was required in 89.6% with a mean duration of 9.1 (SD 9.2) days and emergency surgery was performed in 45.0% of the patients with prolonged ICU and hospital length of stay (10.8 [SD 10.8], 56.9 [SD 96.7] days; respectively). Of the 702 patients with abdomino-pelvic trauma, 115 (16.4%) patients did not survive. Associated head trauma and retroperitoneal haematoma, higher level of lactic acid on admission and ISS, and advanced age were potential risk factors for hospital mortality. CONCLUSIONS:Abdomino-pelvic injuries are common in traumapatients, affecting mainly young male victims, and are associated with significant morbidity and mortality, and resource utilisation.
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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
Authors: Mohamed AbdelRazik; Ibrahim Abdulrahman Alquwaiz; Abdulaziz Abdulrahman Khojah; Abdullah Yahya Alshahrani; Osamah Zeid Aldakkan; Naif Khalid Alhumaydani; Faisal Turki Alqahtani Journal: J Family Med Prim Care Date: 2021-11-05