The distinct and secondary harmful effect of pelvic and extremity injury on the outcome of laparotomy for trauma

Rebecca A. Prince, Christopher J. Hoffman, Richard M. Scanlan, John C. Mayberry

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Hypothesis. Extra-abdominal injury negatively affects the outcome of abdominal injury following trauma laparotomy. Design. Retrospective review of 920 consecutive patients receiving laparotomy for trauma who survived more than 24 h between January 1989 and May 1998 at a Level 1 trauma center. Major abdominal complications (MAC) were defined as: abdominal compartment syndrome (ACS), abscess/peritonitis, enterocutaneous fistula, necrotizing fasciitis, and necrotizing pancreatitis. Methods. Univariant and multivariant logistic regression were used to identify predictors of MAC. Results. Sixty-nine patients (7.5%) developed one or more MAC. Patients who developed MAC had higher injury severity scores (ISS), abdominal trauma indices (ATI), and blood transfusions in the first 24 h (PRCs) than patients who did not develop MAC. Patients with MAC were more likely to have suffered a thoracic or pelvic injury with an abbreviated injury scale (AIS) <3 and were more likely to have received an extremity injury (AIS <3) operation than patients without MAC. Independent predictors of MAC in multivariant analysis included colon injury (AIS <3) [odds ratio (OR) = 3.1, 95% confidence interval (CI) 1.5- 6.3)], pelvic injury (AIS <3) or operation for extremity injury (AIS <3) [OR 2.9, 95% CI 1.5-5.3], and ATI (OR = 1.03 for each 10 unit increase in ATI, 95% CI 1.02-1.05). PRCs did not independently predict MAC. Conclusion. The outcome of laparotomy for trauma (both blunt and penetrating) is negatively affected by a severe pelvic injury or a severe extremity injury operation independent of initial hemorrhage and abdominal injury severity.

Original languageEnglish (US)
Pages (from-to)3-8
Number of pages6
JournalJournal of Surgical Research
Volume124
Issue number1
DOIs
StatePublished - Mar 2005

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Keywords

  • Abdomen
  • Complications
  • Extra-abdominal injury
  • Trauma

ASJC Scopus subject areas

  • Surgery

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