Adnan Sakib M, Anderson Robert G, Madurska Marta J, McNeill Caitlin J, Jansen Jan O, Morrison Jonathan J
R Adams Cowley Shock Trauma Center, University of Maryland Medical System, 22 S. Greene Street, Baltimore, MD, 21201, USA.
Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK.
Eur J Trauma Emerg Surg. 2021 Dec;47(6):1713-1719. doi: 10.1007/s00068-019-01146-w. Epub 2019 May 8.
Traumatic abdominal injury is associated with significant mortality, especially in hemodynamically unstable patients. Trauma management now supports more conservative surgical management with judicious non-operative management. The aim of this study is to use STAG data to characterize abdominal trauma outcomes, focusing on factors that may influence mortality.
A retrospective analysis of prospectively collected STAG data was queried using AIS codes for Scottish abdominal trauma patients between 2011 and 2015. Patients were divided into non-survivor and survivor groups, reflecting mortality. Following this, outcomes and injury patterns of patients undergoing operative or non-operative management were compared between groups.
A total of 1226 were analyzed. The mean age of the cohort was 42.47 ± 19.42 years, with most patients suffering blunt injuries. Non-survivors had more severe injuries to the liver, diaphragm, pancreas, vasculature, and pelvis (p < 0.001, p = 0.005, p = 0.025, p < 0.001, and p < 0.001, respectively). Survivors more often received CT scanning (0.09 [0.03-0.27]) and underwent surgical intervention (57.4% vs 39.7%; p = 0.001). Non-survivors more often had a shorter time till operative intervention (2.6 h vs 6.3 h, p < 0.001).
About 7% of patients in the STAG registry display abdominal injury. Mortality was found to have strong associations with older age, hemodynamic instability, poor neurological status, and head and neck injury. Outcomes may improve with the anticipated creation of the Scottish Trauma System.
创伤性腹部损伤与显著的死亡率相关，尤其是在血流动力学不稳定的患者中。目前的创伤管理支持更保守的手术管理以及明智的非手术管理。本研究的目的是利用STAG数据来描述腹部创伤的结果，重点关注可能影响死亡率的因素。
使用AIS编码对2011年至2015年期间苏格兰腹部创伤患者前瞻性收集的STAG数据进行回顾性分析。患者被分为非幸存者和幸存者组，以反映死亡率。在此之后，比较两组接受手术或非手术治疗的患者的结果和损伤模式。
共分析了1226例患者。队列的平均年龄为42.47±19.42岁，大多数患者遭受钝性损伤。非幸存者的肝脏、膈肌、胰腺、血管系统和骨盆损伤更严重（分别为p<0.001、p = 0.005、p = 0.025、p<0.001和p<0.001）。幸存者更常接受CT扫描（0.09[0.03 - 0.27]）并接受手术干预（57.4%对39.7%；p = 0.001）。非幸存者直到手术干预的时间通常更短（2.6小时对6.3小时，p<0.001）。
STAG登记册中约7%的患者存在腹部损伤。发现死亡率与老年、血流动力学不稳定、神经状态不佳以及头颈部损伤密切相关。随着苏格兰创伤系统的预期建立，结果可能会得到改善。
