Ayman El-Menyar1,2, Husham Abdelrahman3, Ammar Al-Hassani3, Ruben Peralta3, Hiba AbdelAziz3, Rifat Latifi4, Hassan Al-Thani3. 1. Clinical Medicine, Weill Cornell Medical School, Doha, Qatar. aymanco65@yahoo.com. 2. Clinical Research, Trauma Surgery Section, Department of Surgery, Hamad General Hospital (HGH), PO Box 3050, Doha, Qatar. aymanco65@yahoo.com. 3. Department of Surgery, Trauma Surgery Section, HGH, Doha, Qatar. 4. Department of Surgery, Westchester Medical Center, Valhalla, NY, USA.
Abstract
BACKGROUND: We aimed to describe the pattern of solid organ injuries (SOIs) and analyze the characteristics, management and outcomes based on the multiplicity of SOIs. METHODS: A retrospective study in a Level 1 trauma center was conducted and included patients admitted with blunt abdominal trauma between 2011 and 2014. Data were analyzed and compared for patients with single versus multiple SOIs. RESULTS: A total of 504 patients with SOIs were identified with a mean age of 28 ± 13 years. The most frequently injured organ was liver (45%) followed by spleen (30%) and kidney (18%). One-fifth of patients had multiple SOIs, of that 87% had two injured organs. Patients with multiple SOIs had higher frequency of head injury and injury severity scores (p < 0.05). The majority of SOIs were treated nonoperatively, whereas operative management was required in a quarter of patients, mostly in patients with multiple SOIs (p = 0.01). Blood transfusion, sepsis and hospital stay were greater in multiple than single SOIs (p < 0.05). The overall mortality was 11% which was comparable between the two groups. In patients with single SOIs, the mortality was significantly higher in those who had pancreatic (28.6%) or hepatic injuries (13%) than the other SOIs. CONCLUSION: SOIs represent one-tenth of trauma admissions in Qatar. Although liver was the most frequently injured organ, the rate of mortality was higher in pancreatic injury. Patients with multiple SOIs had higher morbidity which required frequent operative management. Further prospective studies are needed to develop management algorithm based on the multiplicity of SOIs.
BACKGROUND: We aimed to describe the pattern of solid organ injuries (SOIs) and analyze the characteristics, management and outcomes based on the multiplicity of SOIs. METHODS: A retrospective study in a Level 1 trauma center was conducted and included patients admitted with blunt abdominal trauma between 2011 and 2014. Data were analyzed and compared for patients with single versus multiple SOIs. RESULTS: A total of 504 patients with SOIs were identified with a mean age of 28 ± 13 years. The most frequently injured organ was liver (45%) followed by spleen (30%) and kidney (18%). One-fifth of patients had multiple SOIs, of that 87% had two injured organs. Patients with multiple SOIs had higher frequency of head injury and injury severity scores (p < 0.05). The majority of SOIs were treated nonoperatively, whereas operative management was required in a quarter of patients, mostly in patients with multiple SOIs (p = 0.01). Blood transfusion, sepsis and hospital stay were greater in multiple than single SOIs (p < 0.05). The overall mortality was 11% which was comparable between the two groups. In patients with single SOIs, the mortality was significantly higher in those who had pancreatic (28.6%) or hepatic injuries (13%) than the other SOIs. CONCLUSION: SOIs represent one-tenth of trauma admissions in Qatar. Although liver was the most frequently injured organ, the rate of mortality was higher in pancreatic injury. Patients with multiple SOIs had higher morbidity which required frequent operative management. Further prospective studies are needed to develop management algorithm based on the multiplicity of SOIs.
Authors: David C Madoff; Alban Denys; Michael J Wallace; Ravi Murthy; Sanjay Gupta; Edmund P Pillsbury; Kamran Ahrar; Bertrand Bessoud; Marshall E Hicks Journal: Radiographics Date: 2005-10 Impact factor: 5.333
Authors: Ajai K Malhotra; Rifat Latifi; Timothy C Fabian; Rao R Ivatury; S Dhage; Tiffany K Bee; Preston R Miller; Martin A Croce; Jay A Yelon Journal: J Trauma Date: 2003-05