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腹部创伤的频率、原因及模式:一项为期4年的描述性分析。

Frequency, causes and pattern of abdominal trauma: A 4-year descriptive analysis.

作者信息

Arumugam Suresh, Al-Hassani Ammar, El-Menyar Ayman, Abdelrahman Husham, Parchani Ashok, Peralta Ruben, Zarour Ahmad, Al-Thani Hassan

机构信息

Department of Surgery, Trauma Surgery Section, Hamad Medical Corporation (HMC), Doha, Qatar.

Department of Surgery, Trauma Surgery Section, Clinical Research, HMC, Doha, Qatar ; Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar.

出版信息

J Emerg Trauma Shock. 2015 Oct-Dec;8(4):193-8. doi: 10.4103/0974-2700.166590.

Abstract

BACKGROUND

The incidence of abdominal trauma is still underreported from the Arab Middle-East. We aimed to evaluate the incidence, causes, clinical presentation, and outcome of the abdominal trauma patients in a newly established trauma center.

MATERIALS AND METHODS

A retrospective analysis was conducted at the only level I trauma center in Qatar for the patients admitted with abdominal trauma (2008-2011). Patients demographics, mechanism of injury, pattern of organ injuries, associated extra-abdominal injuries, Injury Severity Score (ISS), Abbreviated Injury Scale, complications, length of Intensive Care Unit, and hospital stay, and mortality were reviewed.

RESULTS

A total of 6888 trauma patients were admitted to the hospital, of which 1036 (15%) had abdominal trauma. The mean age was 30.6 ± 13 years and the majority was males (93%). Road traffic accidents (61%) were the most frequent mechanism of injury followed by fall from height (25%) and fall of heavy object (7%). The mean ISS was 17.9 ± 10. Liver (36%), spleen (32%) and kidney (18%) were most common injured organs. The common associated extra-abdominal injuries included chest (35%), musculoskeletal (32%), and head injury (24%). Wound infection (3.8%), pneumonia (3%), and urinary tract infection (1.4%) were the frequently observed complications. The overall mortality was 8.3% and late mortality was observed in 2.3% cases mainly due to severe head injury and sepsis. The predictors of mortality were head injury, ISS, need for blood transfusion, and serum lactate.

CONCLUSION

Abdominal trauma is a frequent diagnosis in multiple trauma and the presence of extra-abdominal injuries and sepsis has a significant impact on the outcome.

摘要

背景

阿拉伯中东地区腹部创伤的发生率仍未得到充分报告。我们旨在评估一家新建创伤中心腹部创伤患者的发生率、病因、临床表现及预后。

材料与方法

对卡塔尔唯一的一级创伤中心收治的腹部创伤患者(2008 - 2011年)进行回顾性分析。回顾了患者的人口统计学资料、损伤机制、器官损伤模式、合并的腹部外损伤、损伤严重程度评分(ISS)、简明损伤定级标准、并发症、重症监护病房住院时间、住院时间及死亡率。

结果

共有6888例创伤患者入院,其中1036例(15%)有腹部创伤。平均年龄为30.6±13岁,大多数为男性(93%)。道路交通事故(61%)是最常见的损伤机制,其次是高处坠落(25%)和重物砸伤(7%)。平均ISS为17.9±10。肝脏(36%)、脾脏(32%)和肾脏(18%)是最常受伤的器官。常见的合并腹部外损伤包括胸部(35%)、肌肉骨骼损伤(32%)和头部损伤(24%)。伤口感染(3.8%)、肺炎(3%)和尿路感染(1.4%)是常见的并发症。总体死亡率为8.3%,2.3%的病例出现晚期死亡,主要原因是严重颅脑损伤和脓毒症。死亡率的预测因素为头部损伤、ISS、输血需求和血清乳酸水平。

结论

腹部创伤是多发伤中常见的诊断,腹部外损伤和脓毒症的存在对预后有重大影响。

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