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

Abstract

Introduction: Abdominal trauma is a major cause of morbidity and mortality in low- and middle-income countries. There is a paucity of trauma data in this region and this study aimed to show the pattern of presentation and outcome of patients with abdominal trauma at a North-Central Nigerian Teaching Hospital. Methods: This was a retrospective, observational study of patients with abdominal trauma who presented at the University of Ilorin Teaching Hospital from January 2013 to December 2019. Patients with clinical and/or radiological evidence of abdominal trauma were identified, and data extracted and analyzed. Results: A total of 87 patients were included in the study. There were 73 males and 14 females (5.2:1) with a mean age of 34.2 years. Blunt abdominal injury occurred in 53 (61%) patients with 10 patients (11%) having concomitant extra-abdominal injuries. A total of 105 abdominal organ injuries occurred in 87 patients with the small bowel being the most frequently injured organ in penetrating trauma, while in blunt abdominal injury, the spleen was most commonly injured. A total of 70 patients (80.5%) had emergency abdominal surgery with a morbidity rate of 38.6% and negative laparotomy rate of 2.9%. There were 15 deaths in the period accounting for 17% of patients with sepsis as the most common cause of death (66%). Shock at presentation, late presentation >12 h, need for perioperative intensive care unit admission, and repeat surgery were associated with a higher risk of mortality ( P < 0.05). Conclusion: Abdominal trauma in this setting is associated with a significant amount of morbidity and mortality. Typical patients present late and with poor physiologic parameters often resulting in an undesirable outcome. There should be steps targeted at preventive policies focused on reducing the incidence of road traffic crashes, terrorism, and violent crimes as well as improving health care infrastructure to cater to this specific group of patients.

Mortality and its predictors in abdominal injury across sub-Saharan Africa: systematic review and meta-analysis

“…Out of the articles we reviewed, five reported the role of shock at presentation in abdominal injury mortality [ 16 , 51 , 53 , 58 , 66 ]. In addition, different studies highlighted the significance of ICU admission [ 53 , 66 ], blunt abdominal injury [ 51 , 66 ], postoperative complications [ 58 , 66 ], and damage control surgery (DCS) [ 16 , 50 ] as predictors of mortality in abdominal injuries across SSA (Table 3 ).…”

Evaluating patient factors, operative management and postoperative outcomes in trauma laparotomy patients worldwide: a protocol for a global observational multicentre trauma study

“…As there are a lack of data on trauma laparotomy globally, performing an accurate sample size calculation is not feasible. Data suggest that 30-day mortality rates following trauma laparotomy in high-income countries (HICs) are around 9% 3 and in low-income and miffleincome countries (LMICs) are around 17% [17][18][19] ; using an alpha value=0.05 and power=80%, to show a difference between HIC and LMIC settings, a total of 552 patients are required to be recruited to the study. Based on data from other observational studies, 3 7 8 we would expect over a 30-day observation period each centre to commit around 3-5 patients to the study.…”

Manajemen Trauma Abdomen pada Tanggap Darurat Bencana

“…Trauma abdomen adalah suatu kerusakan terhadap struktur yang terletak diantara diafragma dan pelvis yang diakibatkan oleh benda tumpul atau tajam (1). Trauma adalah penyebab kematian paling umum untuk semua individu berusia antara 1 dan 44 tahun dan penyebab kematian paling umum ketiga tanpa memandang usia (7). Secara global, sekitar 10% kematian hanya disebabkan oleh trauma.…”