Background. In patients with severe injury, predicting the injury site without using advanced diagnostic modalities can help formulate a diagnosis and treatment plan based on the suspected injury site. Objectives. This study aimed to determine the correlation between the injury site and trauma mechanism in severely injured patients with blunt trauma. Methods. We retrospectively analyzed the clinical characteristics—including age, sex, date of emergency room (ER) visit, time of injury, trauma mechanism (car accident, motorcycle accident, bicycle accident, pedestrian accident, fall, slipping and rolling down, crush injury, assault, and others), final diagnosis, injury severity score, abbreviated injury scale (AIS) score, and injury site—of 1,245 patients in a tertiary trauma center. Results. There was a strong correlation between certain injury sites and specific trauma mechanisms. In particular, most trauma mechanisms were associated with injury to the head and neck, as well as the chest, with a combined frequency of >40.0%. Moreover, when using one-way analysis of variance and Bonferroni’s post hoc tests, there were significant differences in AIS scores 1, 3, 4, and 5 for each trauma mechanism. Conclusion. Generally, when patients with severe injury present to the ER, the injury site can be predicted upon initial assessment based on the trauma mechanism. Based on our study, the injury site predicted by a specific mechanism should be checked repeatedly and additionally through physical examination and imaging tools. This can reduce misdiagnosis and help with accurate diagnosis and treatment.
Background. Although blunt abdominal trauma is sometimes readily identified in patients with trauma, its diagnosis and treatment can be delayed due to various limitations including unconsciousness or unstable vital functions, which may cause shock due to blood loss and sepsis. Confirming the correlation between the specific damage of the abdominal organ and the recommended surgical intervention will allow for predicting abdominal damage based on the specific underlying trauma mechanisms. Objectives. This study aimed to assess the proportion of patients with blunt trauma resulting from intraabdominal injury who received surgical intervention (surgery and angioembolization [A/E]), stratified by trauma mechanism and to examine which organs were damaged per different trauma incident. Methods. We retrospectively analyzed the clinical characteristics of 2,291 patients in a tertiary trauma center. Clinical characteristics included age, sex, injury severity score, trauma mechanism (car, motorcycle, pedestrian, bicycle, ship or train accident, fall, slipping or rolling down, bumping, crush injury, explosion burn, and others), abdominal surgical intervention, damaged organ, and A/E site. Results. One-fourth of the patients with blunt trauma required surgical intervention in the abdomen. In particular, the mesentery or bowel was the main injured area for abdominal surgery in all mechanisms, and the spleen or liver was the main damaged organ subjected to A/E. Therefore, we should consider that a substantial proportion of patients with trauma do require abdominal surgery. In particular, repeated physical examination and imaging tests are necessary when the patients are unconscious or their vital functions are unstable for accurate confirmation of injury.
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