Risk of Infection after Penetrating Abdominal Trauma

Ronald Lee Nichols, Jeffrey W. Smith, Daniel B. Klein, Donald D. Trunkey, Ronald H. Cooper, Michael F. Adinolfi, John Mills

    Research output: Contribution to journalArticle

    262 Scopus citations

    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
    DOIs
    StatePublished - Oct 25 1984

    ASJC Scopus subject areas

    • Medicine(all)

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  • Cite this

    Nichols, R. L., Smith, J. W., Klein, D. B., Trunkey, D. 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. https://doi.org/10.1056/NEJM198410253111701