A diagnostic delay of 5 hours increases the risk of death after blunt hollow viscus injury

The Journal of Trauma
Darren J MalinoskiAli Salim

Abstract

Hollow viscus injuries (HVI) are uncommon after blunt trauma, and accomplishing a timely diagnosis can be difficult. Time to operative intervention has been implicated as a risk factor for mortality, but reports are conflicting. All blunt trauma admissions to an academic level 1 trauma center from January 1992 to September 2005 were retrospectively reviewed. Patients with a diagnosis of blunt HVI were included. Patients who died within 24 hours were excluded. Data regarding patient demographics, injuries, time from admission until laparotomy, length of stay, and mortality were recorded, and a multivariate analysis to determine independent risk factors for mortality was carried out. A p < 0.05 was considered significant. Of 35,033 blunt trauma admissions, there were 195 (0.6%) HVI patients with the following characteristics (data expressed as mean +/- 1 SD): mean age of 35 years +/- 16 years, Injury Severity Score of 17 +/- 11, time from admission to laparotomy of 5.9 hours +/- 5.8 hours, operative blood loss of 1500 mL +/- 1800 mL, and length of stay of 19 days +/- 23 days. Twelve percent presented with a systolic pressure <90 mm Hg and 9% died. Independent risk factors for mortality were age (odds ratio [OR] = 1.04, p = 0.005)...Continue Reading

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Citations

Dec 3, 2013·The Indian Journal of Surgery·Sarita MaguRavinder Singh Gill
Jan 9, 2013·World Journal of Emergency Surgery : WJES·Massimo SartelliTomohisa Shoko
Aug 7, 2014·Journal of Trauma Management & Outcomes·Sigrid GrovenPaal Aksel Naess
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