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. 2024 Feb 13:2024:5215977.
doi: 10.1155/2024/5215977. eCollection 2024.

Comparison of Clinical Characteristics, Therapy, and Short-Term Prognosis between Blunt and Penetrating Abdominal Trauma: A Multicentric Retrospective Cohort Study

Yi Liu  1 , Yunhe Gao  2 , Zhida Chen  3 , Jianxin Cui  1 , Wenquan Liang  2 , Ze Wang  1 , Linde Sun  1 , Chuan Pang  4 , Yuan Lv  5 , Guoxiao Liu  1 , Tingting Lu  3 , Gan Zhang  3 , Xiaoyu Dong  3 , Hong Xu  6 , Sheng Yao  7 , Feng Liang  4 , Gang Liu  8 , Gang Chen  5 , Jianmiao He  9 , Wentong Xu  1 , Bo Wei  1 , Hongqing Xi  1 , Lin Chen  1
Affiliations

Comparison of Clinical Characteristics, Therapy, and Short-Term Prognosis between Blunt and Penetrating Abdominal Trauma: A Multicentric Retrospective Cohort Study

Yi Liu et al. Emerg Med Int. .

Abstract

Objective: Large-scale studies on the characteristics and management of abdominal trauma in megacities in China are lacking. The aim of this study was to analyze and present the clinical patterns and treatment status of abdominal trauma in regional medical centers.

Methods: Cases of abdominal trauma treated at seven medical centers in Beijing from 2010 to 2021 were collected. Clinical information about age, sex, injury cause, geographic distribution, abbreviated injury scale/injury severity score (AIS/ISS) value, injury-hospital time, preoperative time, surgically identified organ injuries, type of surgery, causes of reoperation and 90-day mortality was included in this study. Clinical characteristics, treatment methods, and short-term prognoses (90-days survival) were compared between blunt abdominal trauma (BAT) and penetrating abdominal trauma (PAT) cases. Non-normally distributed data are described as medians (IQR), and the Mann‒Whitney U test was performed; qualitative data were analyzed using the X2 test. Univariate and multivariate survival analyses were performed by the Cox proportional hazards model.

Results: A total of 553 patients (86.98% male) with a median age of 36.50 (27.00-48.00) years were included. The BAT group had a significantly higher proportion of serious injury (P=0.001), lower initial hemoglobin level (P=0.001), and a lower laparoscopy surgery rate (P=0.044) compared to the PAT group. Additionally, more BAT cases were from the area around Beijing (P=0.008) and a longer injury-regional hospital time (10.47 (5.18-22.51) hours vs. 7.00 (3.80-15.38) hours, P=0.001). In the hollow viscus injury subgroup, the BAT group had a significantly longer injury-regional hospital time and preoperative time compared to the PAT group (injury-regional hospital time: 10.23 (6.00-21.59) hours vs. 7.07 (3.99-13.85) hours, P=0.002; preoperative time: 3.02 (2.01-5.58) hours vs. 2.81 (1.85-3.63) hours, P=0.047). The overall 90-day mortality was 11.9%, and longer injury-regional hospital time (HR: 1.01, 95% CI: 1.00-1.02, P=0.008), receipt of ICU treatment (HR: 4.69, 95% CI: 2.54-8.65, P=0.001), and severe ISSs (ISS > 25 vs. ISS < 16, HR: 2.78, 95% CI: 1.38-5.601, P=0.004) had a worse impact on survival.

Conclusion: More patients with BAT were transferred to higher-level hospital, leading to significantly longer prehospital and preoperation time. In the subgroup of hemodynamically stable individuals, more patients with BAT experienced hollow viscus injuries. For those patients, aggressive diagnostic laparoscopic exploration may be beneficial. Patients with longer injury-regional hospital intervals, the need for ICU care, and higher injury severity scores (ISSs) suffered from worse prognoses.

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Conflict of interest statement

All the authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Selection flowchart.
Figure 2
Figure 2
The geographical distribution of enrolled patients.
Figure 3
Figure 3
ICU stays and postoperative hospital stays.
Figure 4
Figure 4
Complications encountered during treatment.
Figure 5
Figure 5
Kaplan–Meier survival plot for abdominal trauma patients. (a) 90-day survival in overall population; (b) 90-day survival by ISS scores; (c) 90-day survival by ICU treatment.
See this image and copyright information in PMC

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References

    1. Pham J., Kemp J., Pruitt J. Acute abdomen in adult trauma. Seminars in Roentgenology . 2020;55(4):385–399. doi: 10.1053/j.ro.2020.06.003. - DOI - PubMed
    1. Japan trauma data bank. Japan trauma data bank report2020. powerpoint (jtcr-jatec.org) 2022. https://www.jtcr-jatec.org/traumabank/dataroom/data/JTDB2020e.pdf .
    1. Bates D. D., Wasserman M., Malek A., et al. Multidetector CT of surgically proven blunt bowel and mesenteric injury. RadioGraphics . 2017;37(2):613–625. doi: 10.1148/rg.2017160092. - DOI - PubMed
    1. Belmont P. J., Jr, McCriskin B. J., Sieg R. N., Burks R., Schoenfeld A. J. Combat wounds in Iraq and Afghanistan from 2005 to 2009. Journal of Trauma and Acute Care Surgery . 2012;73(1):3–12. doi: 10.1097/ta.0b013e318250bfb4. - DOI - PubMed
    1. Cardi M., Ibrahim K., Alizai S. W., et al. Injury patterns and causes of death in 953 patients with penetrating abdominal war wounds in a civilian independent non-governmental organization hospital in lashkargah, Afghanistan. World Journal of Emergency Surgery . 2019;14(1):p. 51. doi: 10.1186/s13017-019-0272-z. - DOI - PMC - PubMed

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