The Abdominal Trauma Index—A Critical Reassessment and Validation

Borlase, Bradley C.; Moore, Ernest E.; Moore, Frederick A.

doi:10.1097/00005373-199011000-00006

Cited by 69 publications

(31 citation statements)

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“…The data collected included demographics, gender, age, mechanism of injury, admission vital signs, time elapsed between injury and operation, site and grade of duodenal injury, associated organ injuries, surgical procedure used, presence of complications (including duodenal fi stula) and mortality. The trauma indices used included the Revised Trauma Score (RTS), 8 Injury Severity Score (ISS) 9 and Abdominal Trauma Index (ATI), 10 and duodenal injuries were classifi ed using the American Association for the Surgery of Trauma -Organ Injury Scale (AAST-OIS).…”

Section: Methodsmentioning

confidence: 99%

The use of pyloric exclusion for treating duodenal trauma: case series

et al. 2008

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CONTEXT AND OBJECTIVES: Signifi cant controversy exists regarding the best surgical treatment for complex duodenal injuries. The aims of this study were to report on a series of eight cases of duodenal repairs using pyloric exclusion and to describe reported complications or improvements in clinical outcomes among patients with complex duodenal trauma. DESIGN AND SETTING:Cross-sectional study followed by a case series in a university hospital. METHODS:Data on eight patients with duodenal trauma who underwent pyloric exclusion over a 17.5 year period were collected and analyzed. RESULTS:The causes of the injuries included penetrating gunshot wounds (GSW) in fi ve patients and motor vehicle accidents (blunt trauma) in three patients. The time elapsed until surgery was longer in the blunt trauma group, while in one patient, the gunshot injury was initially missed and thus the procedure was carried out 36 hours after the original injury. The injuries were grade III (50%) or IV (50%) and the morbidity rate was 87.5%. Four patients (50%) died during the postoperative period from complications, including hypovolemic shock (one patient), sepsis (peritonitis following the missed injury) and pancreatitis with an anastomotic fi stula (two patients).CONCLUSIONS: Pyloric exclusion was associated with multiple complications and a high mortality rate. This surgical technique is indicated for rare cases of complex injury to the duodenum and the surgeon should be aware that treatment with a minimalistic approach, with only primary repair, may be ideal.

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Section: Methodsmentioning

confidence: 99%

The use of pyloric exclusion for treating duodenal trauma: case series

et al. 2008

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“…5 Thus, this study has focused on abdominal trauma in tertiary care centre to identify the risk factors that have detrimental effect in prognosis. Trauma scores system besides predicting the outcome can act as benchmark upon which improvement of trauma care system is possible.…”

Section: In 2010mentioning

confidence: 99%

Predictors of Surgical Outcome of Abdominal Trauma in Tertiary Care Centres of Nepal

Thapa

Gurung

Basnet

et al. 2017

Med. J. Shree Birendra Hosp.

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Introduction: The abdominal trauma is a surgical emergency most of which are preventable and many of them could have good outcome with timely management by dedicated trauma system. It is not only the rising health problem but also the social and economic burden. A study on abdominal trauma can guide to cost-effective quality management of the patients. This study is undertaken to study and evaluate the predictors of surgical outcome in abdominal trauma patients in tertiary care centers in Nepal.Methods: Seventy five patients with abdominal trauma who underwent surgical intervention were evaluated prospectively inside the inclusion criteria. Ethical approval was obtained. The data on demographic pattern, clinic-radiological findings, abdominal trauma index, injury severity scale, operative findings, infectious complications, and mortality were collected. Chi square test was used for statistical analysis. Results: Out of 75 patients male to female ratio was 4.6 : 1. Blunt trauma (49) was the common cause of abdominal injury. Accidental abdominal injury happened in 73% (55) and fall from height was common mode of abdominal organ injury 40% (30). The overall morbidity and mortality were 30.6% and 9.3% respectively. Age > 30 years, Shock at presentation, Operative Delay > 24 hours, and trauma score (ATI>15 and ISS>15) were all good predictors of surgical outcome of patients with abdominal trauma (p <0.05).Conclusion: The predictors of surgical outcome were patient’s age, clinical status at presentation and delay in surgical intervention. Trauma score (both ATI and ISS) are equally important in predicting outcome which are necessary for monitoring patients care and the quality of trauma systems.

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“…A vantagem deste índice é considerar todas as lesões intra-abdominais, independente de sua gravidade, porém não considera lesões em outros segmentos do corpo que também afetam a morbimortalidade. Pacientes que apresentam ATI maior que 25 têm elevado risco de desenvolver complicações e evoluir para óbito (6,22) .…”

Section: Métodounclassified

Trauma do pâncreas: fatores preditivos de morbidade e mortalidade relacionados a índices de trauma

Silveira¹,

Mantovani²,

Fraga³

2009

Arq. Gastroenterol.

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RESUMO -Contexto -Embora incomuns, lesões traumáticas do pâncreas estão associadas a significativos níveis de complicações e mortalidade. Objetivo -Definir os fatores preditivos de morbidade e mortalidade em pacientes vítimas de trauma pancreático. Houve maior morbidade e mortalidade em pacientes com lesões complexas (graus IV e V) do pâncreas quando comparadas com lesões menos graves (graus I e II), porém a morbidade e mortalidade neste grupo não foram desprezíveis, devido a valores alterados de escore de trauma revisado ("revised trauma score"), valores elevados de índice de gravidade da lesão ("injury severity score") e "abdominal trauma index". Conclusões -Valores alterados de "revised trauma score", pressão arterial sistólica menor que 90 mm Hg, valor de "injury severity score" menor ou igual a 15 e valor de "abdominal trauma index" maior ou igual a 25 são fatores relacionados a aumento da morbidade. Valores anormais de "revised trauma score", valores de "injury severity score" e "abdominal trauma index" superiores a 25, pressão arterial sistólica inferior a 90 mm Hg são fatores preditivos de aumento de mortalidade em pacientes vítimas de trauma pancreático. Valores baixos do índice misto, anatômico e fisiológico denominado TRISS, são preditivos de maior morbidade e mortalidade, porém valores elevados deste índice não são preditivos de boa evolução. DESCRITORES -Pâncreas, lesões. Índices de gravidade do trauma. INTRODUÇÃOAs principais causas de morte entre indivíduos com idade até 35 anos são externas, resultantes do aumento contínuo da violência. O abdome é frequentemente acometido tanto por lesões penetrantes quanto por traumas fechados (14,22,23) . O pâncreas é um órgão de localização retroperitonial, na porção central do andar superior do abdome, medindo de 15 a 20 cm de comprimento e com massa de 80 a 90 g. Devido a sua proximidade com outras estruturas, tais como aorta, veia cava, veia porta, vasos mesentéricos, estômago, cólon e sua íntima relação com o duodeno, lesões isoladas do pâncreas são pouco frequentes, ocorrendo em apenas 2% dos traumatismos abdominais, sendo decorrentes em dois terços das vezes de traumas penetrantes e em um terço de traumas abdominais fechados. Em casos de trauma abdominal fechado, devido a sua proximidade com a coluna vertebral, o pâncreas é lesado entre 3% e 12% das vezes (17, 19, 21, 25, 26, 28,) .Cerca de 75% das lesões pancreáticas são simples, constituindo-se apenas em hematoma, lesão da cápsula ou lesão do parênquima, sem acometimento do ducto pancreático principal (19) .A mortalidade das lesões pancreáticas, ao contrário de sua baixa incidência, é elevada, atingindo acima de 50% dos casos onde há lesão complexa do órgão (19,20,24,30) . O óbito ocorre em até 75% das vezes nas primeiras 48 horas após o trauma, decorrente de hemorragia. Infecção e falência de múltiplos órgãos são responsáveis pelos demais casos de óbito (1,3) . Lesões associadas de pâncreas e duodeno compreendem menos de 10% das lesões pancreáticas, porém estão associadas a maior índice de complicaçõ...

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The Abdominal Trauma Index—A Critical Reassessment and Validation

Cited by 69 publications

References 0 publications

The use of pyloric exclusion for treating duodenal trauma: case series

The use of pyloric exclusion for treating duodenal trauma: case series

Predictors of Surgical Outcome of Abdominal Trauma in Tertiary Care Centres of Nepal

Trauma do pâncreas: fatores preditivos de morbidade e mortalidade relacionados a índices de trauma

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