An outcome prediction model for exsanguinating patients with blunt abdominal trauma after damage control laparotomy: a retrospective study

نویسندگان

  • Shang-Yu Wang
  • Chien-Hung Liao
  • Chih-Yuan Fu
  • Shih-Ching Kang
  • Chun-Hsiang Ouyang
  • I-Ming Kuo
  • Jr-Rung Lin
  • Yu-Pao Hsu
  • Chun-Nan Yeh
  • Shao-Wei Chen
چکیده

BACKGROUND We present a series of patients with blunt abdominal trauma who underwent damage control laparotomy (DCL) and introduce a nomogram that we created to predict survival among these patients. METHODS This was a retrospective study. From January 2002 to June 2012, 91 patients underwent DCL for hemorrhagic shock. We excluded patients with the following characteristics: a penetrating abdominal injury, age younger than 18 or older than 65 years, a severe or life-threatening brain injury (Abbreviated Injury Scale [AIS] ≥ 4), emergency department (ED) arrival more than 6 hours after injury, pregnancy, end-stage renal disease, or cirrhosis. In addition, we excluded patients who underwent DCL after ICU admission or later in the course of hospitalization. RESULTS The overall mortality rate was 61.5%: 35 patients survived and 56 died. We identified independent survival predictors, which included a preoperative Glasgow Coma Scale (GCS) score < 8 and a base excess (BE) value < -13.9 mEq/L. We created a nomogram for outcome prediction that included four variables: preoperative GCS, initial BE, preoperative diastolic pressure, and preoperative cardiopulmonary cerebral resuscitation (CPCR). CONCLUSIONS DCL is a life-saving procedure performed in critical patients, and devastating clinical outcomes can be expected under such dire circumstances as blunt abdominal trauma with exsanguination. The nomogram presented here may provide ED physicians and trauma surgeons with a tool for early stratification and risk evaluation in critical, exsanguinating patients.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Risk factors for mortality in blunt abdominal trauma with surgical approach.

OBJECTIVE identify risk factors for mortality in patients who underwent laparotomy after blunt abdominal trauma. METHODS retrospective study, case-control, which were reviewed medical records of blunt trauma victims patients undergoing laparotomy, from March 2013 to January 2015, and compared the result of the deaths group with the group healed. RESULTS of 86 patients, 63% were healed, 36% ...

متن کامل

Avoidance of abdominal compartment syndrome in damage-control laparotomy after trauma.

HYPOTHESIS Abdominal compartment syndrome (ACS) is a morbid complication of damage-control laparotomy. Moreover, the technique of abdominal closure influences the frequency of ACS. DESIGN Retrospective cohort study. SETTING Urban level I trauma center. PATIENTS We studied 52 patients with trauma who required damage-control laparotomy during the 5 years ending December 31, 1999, and who su...

متن کامل

ارزش تشخیصی تست پریتونئال لاواژ در تشخیص آسیب ارگانهای داخل شکمی متعاقب تروماهای شکمی در مقایسه با لاپاراتومی و درمان نگاهدارنده

Introduction: Prevalence of abdominal trauma is increasing during recent years. Abdomen is the third most affected part of body by trauma. Early diagnosis can help us select better methods for managing abdominal trauma. Even though newer imaging techniques such as CT scan are available, abdominal trauma is still a complex matter, which every doctor in the emergency department has to deal with. ...

متن کامل

Predicting mortality in damage control surgery for major abdominal trauma.

BACKGROUND Damage control surgery (DCS) has become well established in the past decade as the surgical strategy to be employed in the unstable trauma patient. The aim of this study was to determine which factors played a predictive role in determining mortality in patients undergoing a damage control laparotomy. MATERIALS AND METHODS A retrospective review of all patients undergoing a laparot...

متن کامل

Penetrating abdominal injuries in an emerging semi-urban teaching hospital

Objective: There has been a worldwide rise in the prevalence of penetrating abdominal injury (PAI), and there are both inter-country and intra-country variations in frequencies. This study evaluates the mechanisms and pattern of penetrating abdominal injuries and the treatment outcome in our center.Methods: This descriptive study of adult patients managed for PAI was conducted at the Ekit...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 14  شماره 

صفحات  -

تاریخ انتشار 2014