Solid viscus injury predicts major hollow viscus injury in blunt abdominal trauma. Discussion.
Annual Meeting of the American Association for the Surgery of Trauma. Houston, Texas (USA), 1996/09/19.
As nonoperative management of blunt abdominal trauma has become more popular, reliable models for predicting the likelihood of concomitant hollow viscus injury in the hemodynamically stable patient with a solid viscus injury are increasingly important.
The Pennsylvania Trauma Systems Foundation registry was reviewed for the period from January 1992 to December 1995 for all adult (age>12 years) patients with blunt trauma and an Abbreviated Injury Scale (AIS) score = 2 for a solid viscus (kidney, liver, pancreas, spleen).
Patients with an initial systolic blood pressure<90 mm Hg were excluded.
Hollow viscus injuries included only lacerations or perforations of the gallbladder, gastrointestinal tract, or urinary tract.
In the 4-year period, 3,089 patients sustained solid viscus injuries, 296 of whom had a hollow viscus injury (9.6%). The mean age was 35.6 years, mean Injury Severity Score was 22.2, and mean Revised Trauma Score was 7.3 ; 63.3% of the patients were male.
A solitary solid viscus injury occurred in 2,437 patients (79%), 177 of whom (7.3%) had a hollow viscus injury.
The frequency of hollow viscus injury increased with the number of solid organs injured : 15.4% of patients with two solid viscus injuries (n=547) and 34.4% of patients with three solid viscus injuries (n=96) suffered a concomitant hollow viscus injury (p<0.001 vs. one organ).
A hollow viscus injury was 2.3 times more likely for two solid viscus injuries and 6. (...)
Mots-clés Pascal : Traumatisme, Abdomen, Homme, Epidémiologie, Incidence, Association, Viscère, Facteur prédictif, Perforation, Intestin, Voie biliaire, Voie urinaire pathologie, Abdomen pathologie, Appareil digestif pathologie, Intestin pathologie, Voie biliaire pathologie, Appareil urinaire pathologie
Mots-clés Pascal anglais : Trauma, Abdomen, Human, Epidemiology, Incidence, Association, Viscus, Predictive factor, Perforation, Gut, Biliary tract, Urinary tract disease, Abdominal disease, Digestive diseases, Intestinal disease, Biliary tract disease, Urinary system disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0002160
Code Inist : 002B16G. Création : 17/04/1998.