Pattern and Outcome of Assaulted Penetrating Thoracic and Abdominal Trauma Cases: A Two Years Prospective Study

Abstract

Background: There is a worldwide increase in the prevalence of assaulted penetrating thoracic and abdominal trauma which may lead to disabilities and death. Aim: To describe the pattern and predictors of outcome in assaulted penetrating thoracic and abdominal trauma. Methods: A two years prospective study was conducted on 123 patients with assaulted penetrating thoracic and abdominal trauma who were admitted to Menoufia University Hospital during the period from the 1 st January 2017 to the 31 th December 2018. For each case, demographic data, circumstances of trauma were taken. Also, general and local examination of injury was performed and findings in penetrating wounds were reported after investigation and surgical explorations. Outcome of cases either death or survived was determined. Results: Abdominal injuries constituted 58.5% while thoracic injury was presented (31.7%) of cases. The most frequent subjects aged from 20-<30 years (46.3%), males (95.1%) and stab was the most common cause of injury (90.3%).The intestinal injury was the most frequently injured organ (16.3%) followed by spleen (12.2).The majority of patients survived (90.2%) and only 9.8% died. Mechanical ventilation, hypotension, delayed time for hospital arrival, gunshot injury, organ injury, hemoperitoneum and combined thoracic and abdominal injuries were the most predicting factor for mortality in the studied cases Conclusion: Penetrating thoracic and abdominal injuries caused by assault were common among middle aged single males and caused by stab. Delayed hospital arrival, hypotension and combined thoracic and abdominal injuries and gunshot trauma were predictors of death among the studied cases. The overall outcome was satisfactory. Recommendations: Rapid emergency transport of victims and rapid resuscitation should help to reduce the mortality from penetrating thoracic and abdominal injuries. Also, preventive strategies focused on reduction of violent crimes and social conflicts were necessary.