Determinants of outcome of abdominal trauma in an urban tertiary center

Abstract

Background:Abdominal trauma constitutes a significant cause of potentially preventable mortality. Therefore, knowledge of the determinants of outcome facilitates the development of rational treatment protocols for improving outcome.Objective:To identify the determinants of outcome in patients with abdominal trauma managed in a tertiary health center.Patients and Methods:This is a prospective study of consecutive patients presenting with abdominal trauma to our tertiary health center over a 12-month period. Data regarding patient demographics, injury mechanisms, type of organ injuries, treatment modalities, injury-to-intervention time, and outcomes were documented. The Injury Severity Scores and Revised Trauma Scores were determined. The data were analyzed using the Statistical Package for the Social Sciences version 20.Results:There were 76 patients, 66 males and 10 females, whose ages ranged from 15 to 66 years (mean of 32.9 ± 10 years). Thirty-one (40.2%) patients had blunt abdominal trauma whereas 45 (59.8%) patients had penetrating trauma. There was a mortality rate of 8% predominantly from blunt trauma as compared to penetrating abdominal trauma (12.9% vs. 4.4%). There was a statistically significant difference between survivors and nonsurvivors as regards the means of injury-to-intervention time (25.4 ± 36.4 vs. 67.5 ± 58.2, P = 0.007), the means of Injury Severity Scores (15.1 ± 27.9 vs. 23.7 ± 9.8, P = 0.008), and the presence of brain injury (50.0% vs. 5.6%, P = 0.029).Conclusion:This study has shown that delayed intervention, high Injury Severity Score, and associated significant brain injury were determinants of poor outcomes. Prompt intervention and postoperative management in intensive care definitely improve outcome.

Pattern of Presentation and Outcome of Adult Patients with Abdominal Trauma – A 7-Year Retrospective Study in a Nigerian Tertiary Hospital

“…This pattern of injury conforms to studies done elsewhere. [ 11 , 22 23 24 ] Two negative laparotomies occurred in the study accounting for 2.9% of all cases. A negative laparotomy is defined as one in which there is no evidence of intraabdominal injury.…”

“…This is similar to local and international studies. [ 9 , 11 , 14 , 15 ] Young people are active in commercial activities and their involvement leads to a significant loss of man-hours and subsequent impact on economic activities.…”

“…Agbroko et al . reported that just 6.7% of patients presented and had definitive procedure within 6 h.[ 11 ] The three-delay model is often used to describe delays following acute emergencies such as trauma. The delays include (1) the decision to seek care, (2) reaching definitive care, and (3) receiving definitive care.…”

“…Recent reports show a rising domination of penetrating injury characterized by increased gunshot injuries, missiles, and blasts. [ 11 , 21 22 23 ]…”

“…This is worsened as there are no effective trauma registries locally and record-keeping methods are inefficient. There are some studies describing patients with abdominal trauma originating from South Nigeria,[ 8 , 10 11 12 ] but there appears to be a paucity of information arising from the North-central region. Therefore, this study was conducted to highlight the presentation and outcome of patients with abdominal trauma at the University of Ilorin Teaching Hospital, a tertiary facility in North-central Nigeria.…”