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

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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
Publication statusPublished - 1984
Externally publishedYes

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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