The abdominal trauma index(ATI) has been used to classify patients with abdominal trauma and has been validated as a predictor of morbidity and mortality following abdominal trauma.
We attempted to determine whether the ATI is a useful index to evaluate multiple trauma patients with abdominal injury.
A Total of 284 patient (214 blunt and 70 penetrating injury) who underwent laparotomy of Department of Surgery, Kangnam Sacred Heart Hospital were retrospectively reviewed from January 1989 through December 1993.
The risk of morbidity and mortality were quantitated by using ATI and TRISS methodology.
The risk of morbidity rate was 13.0%(37/284). According to injury mechanism, the morbidity rate was 14.6%(20/137) for motor vehicle crash(MVC), 10.4%(8/77) for blunt trauma, and 12.9%(9/70) for penetrating trauma. The morbidity rate was
21.9%(7/32)
for
patients with ATI of more than 25 and 11.9%(30/352) for patients with ATI of less than 25. The overall mortality rate was 5.6(16/284). According to injury mechanism, the mortality rate was 5.6%(16/284). According to injury mechanism, the
mortality
rate
was 9.5%(13/137) for MVC, 1.4%(1/77) for blunt trauma, and 2.9%(2/70) for patients with penetrating trauma. The mortality rate was 25.0(8/32) for patients with ATI of more than 25 and 3.2%(8/252) for patients with ATI of less than 25. Of 16
non-survivor, predicted death using TRISS methodology was 15 cases and unpredicted death using TRISS methodology was one case. In eight predicted death patients with ATI of less than 25, the cause of death was directly associated with other body
injuries rather than abdominal injury. In seven predicted death patients with ATI of more than 25, the cause of death was directly associated with abdominal injury. One patient had a high probability of survival by TRISS mothodology, but was
included in
a high risk patient of death by the ATI score and the cause of death was hypovolemic shock due to inferior venal caval injury.
These results suggest that the ATI is a valid predictor of mobidity and mortality in patients with abdominal injury only and may be useful in conjunction with other indives to assess multiple trauma patients with abdominal injury.
|