Risk of infection after penetrating abdominal trauma

R. L. Nichols, J. W. Smith, D. B. Klein, Donald Trunkey, R. H. Cooper, M. F. Adinolfi, J. Mills

Research output: Contribution to journalArticle

261 Citations (Scopus)

Abstract

To identify the risk factors for the development of postoperative septic complications in patients with intestinal perforation after abdominal trauma, and to compare the efficacies of single-drug and dual-drug prophylactic antibiotic therapy, we studied 145 patients who presented with abdominal trauma and intestinal perforation at two hospitals between July 1979 and June 1982. Logistic-regression analysis showed that a higher risk of infection (P <0.05) was associated with increased age, injury to the left colon necessitating colostomy, a larger number of units of blood or blood products administered at surgery, and a larger number of injured organs. The presence of shock on arrival, which was found to increase the risk of infection when this factor was analyzed individually, did not add predictive power. Patients with postoperative sepsis were hospitalized significantly longer than were patients without infection (13.8 vs. 7.7 days, P <0.0001). Both treatment regimens - cefoxitin given alone and clindamycin and gentamicin given together - resulted in similar infection rates, drug toxicity, duration of hospitalization, and costs.

Original languageEnglish (US)
Pages (from-to)1065-1070
Number of pages6
JournalNew England Journal of Medicine
Volume311
Issue number17
StatePublished - 1984
Externally publishedYes

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Intestinal Perforation
Wounds and Injuries
Infection
Cefoxitin
Colostomy
Clindamycin
Gentamicins
Drug-Related Side Effects and Adverse Reactions
Pharmaceutical Preparations
Shock
Sepsis
Colon
Hospitalization
Logistic Models
Regression Analysis
Anti-Bacterial Agents
Costs and Cost Analysis
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Nichols, R. L., Smith, J. W., Klein, D. B., Trunkey, D., Cooper, R. H., Adinolfi, M. F., & Mills, J. (1984). Risk of infection after penetrating abdominal trauma. New England Journal of Medicine, 311(17), 1065-1070.

Risk of infection after penetrating abdominal trauma. / Nichols, R. L.; Smith, J. W.; Klein, D. B.; Trunkey, Donald; Cooper, R. H.; Adinolfi, M. F.; Mills, J.

In: New England Journal of Medicine, Vol. 311, No. 17, 1984, p. 1065-1070.

Research output: Contribution to journalArticle

Nichols, RL, Smith, JW, Klein, DB, Trunkey, D, Cooper, RH, Adinolfi, MF & Mills, J 1984, 'Risk of infection after penetrating abdominal trauma', New England Journal of Medicine, vol. 311, no. 17, pp. 1065-1070.
Nichols RL, Smith JW, Klein DB, Trunkey D, Cooper RH, Adinolfi MF et al. Risk of infection after penetrating abdominal trauma. New England Journal of Medicine. 1984;311(17):1065-1070.
Nichols, R. L. ; Smith, J. W. ; Klein, D. B. ; Trunkey, Donald ; Cooper, R. H. ; Adinolfi, M. F. ; Mills, J. / Risk of infection after penetrating abdominal trauma. In: New England Journal of Medicine. 1984 ; Vol. 311, No. 17. pp. 1065-1070.
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