Penetrating esophageal injuries : Time interval of safety for preoperative evaluation-how long is safe ?
This study was performed to assess the experience with penetrating esophageal injuries of an urban Level I trauma center and to attempt to correlate the time to establish a diagnosis with outcome including death, surgical intensive care unit length of stay, and esophageal-related complications.
Retrospective study over a 72-month period at a single institution comparing age, admission blood pressure, Revised Trauma Score (RTS), Injury Severity Score (ISS), mechanism and anatomic location of injury, and time interval from admission to the operating room (OR) between nonsurvivors and survivors.
Patients who survived to reach the operating room were divided into two groups : those who went immediately to the operating room (no preoperative evaluation) and those who underwent diagnostic studies to identify their injuries (preoperative evaluation).
Data analysis was done of the same parameters plus average number of associated injuries, complications, and intensive care unit length of stay.
Statistical methods used univariate analysis (Fisher's exact test and Student's t test).
Forty-three patients were identified with penetrating esophageal injuries and had the following characteristics :
36 males (84%) and 7 females (16%) ;
mean RTS, 9.39 ;
mean ISS, 28.1 ;
mean time interval to OR, 9.8 hours.
Associated injuries occurred with 42 patients (98%). The overall complication rate was 14 of 32 (44%), and the overall mortality was 11 of 43 (26%). (...)
Mots-clés Pascal : Plaie pénétrante, Oesophage, Influence, Temps attente, Diagnostic, Préopératoire, Morbidité, Mortalité, Evolution, Complication, Résultat, Homme, Traumatisme, Appareil digestif pathologie, Oesophage pathologie, Chirurgie
Mots-clés Pascal anglais : Penetrating injury, Esophagus, Influence, Waiting time, Diagnosis, Preoperative, Morbidity, Mortality, Evolution, Complication, Result, Human, Trauma, Digestive diseases, Esophageal disease, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0484863
Code Inist : 002B16G. Création : 03/02/1998.