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KMID : 0360720070200010012
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Journal of the Korean Society Traumatology
2007 Volume.20 No. 1 p.12 ~ p.18
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Analysis of the Prognostic Factors for Abdominal Trauma
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Kim Hee-Joon
Kim Hyung-Soo
Seo Kyeong-Won
Ju Jae-Kyun
Ryu Seong-Yeop
Park Young-Kyu
kim Hyeong-Rok
Kim Dong-Yi
Kim Young-Jin
Kim Shin-Kon
Kim Jung-Chul
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Abstract
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Purpose: Recently, trauma is more frequent due to the increases in the population, the number of traffic accident,
and the incidence of violence. Especially, abdominal trauma is a leading cause of morbidity and mortality.
We analyzed the clinical features and the factors associated with morbidity and mortality.
Methods: We analyzed 136 patients of abdominal trauma who were admitted at the Department of Surgery,
Chonnam National University Hospital, from January 2003 to June 2005. We analyzed the cause of trauma, the
injured organ, combined injuries, mental status, blood pressure, laboratory findings, morbidity, and mortality.
The relationships between by variable were assesed by using the independent samples test and the
Kruskal?Wallis test.
Results: The causes of trauma were traffic accidents (98 cases, 72%), falling accidents (9 cases, 6.6%), violence
(6 cases, 4.4%), and stab injuries (6 cases, 4.4%). The injured organs were the small intestines (47 cases,
34.6%), the liver (35 cases, 25.7%), the spleen (26 cases, 19.1%), the mesentery (17 cases, 12.5%), the large
intestines (15 cases, 11.0%), the pancreas (14 cases, 10.3%), etc. The most common combined injury was chest
injury (53 cases, 39%). Comatose or semicomatose mental status and shock on admission (<60 mmHg in systolic)
were related to high mortality (85.7%). In laboratory findings, decreased hemoglobin (<8 g/dL), and
platelet count (<50,000/mm3), and increased creatinine level (>1.6 mg/dL) were significant prognostic factors.
The incidence of postoperative complications was 40.4%, and frequent complications were wound infection
(8.1%) and re-bleeding (8.1%). The overall mortality rate was 18.4%, and most common cause was hypovolemic
shock (18 cases, 13.2%), however, there was no statistical difference according to injurd organ.
Conclusion: In the multivariate analysis, mental status, hemoglobin, and serum creatinine level were the
most significant prognostic factors. When an abdominal trauma patient arrives at the emergency room, a rapid
and accurate evaluation of the patient’s status and risk factors, and resuscitation, if necessary, have to be performed
to lower the morbidity and mortality.
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KEYWORD
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Abdominal trauma, Prognostic factor
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