Factors Affecting Mortality in Blunt Abdominal Trauma

ABSTRACT

To evaluate the risk factors affecting mortality in blunt abdominal injury we prospectively analysed 149 abdominal traumatic patients, who were performed laparotomy in 84 cases and conservative management in 65 cases, from January 1st. 1995 to September 30th. 1996. The liver was most frequently injured intraabdominal organ(46.3%), followed by spleen(32.9%), kidney(23.5%), small intestine(16.1%) and mesentery(13.4%). Mortality rate was 19.5%. The cause of death was hemorrhagic shock and its complications in 11 cases, craniocerebral injuries in 7 cases, pulmonary complications in 6 cases, and septic shock in 5 cases. The presence of hypotension(less than 90mmHg), head trauma(above 3 in severity code of abbreviated injury scale(AIS)) and chest trauma(hemothorax and/or pneumothorax) was associated with a high mortality rate(88.9%), but the mortality rate for the patients neither hypotension nor head and chest trauma was very low(1.8%). The mortality in the blunt abdominal injuries was highly influenced by hypotension, head injury and multiple intraabdominal injuries(p<0.05). Of the above influencing risk factors, the associated head injury was the most powerful determinant in the prognosis in the patients of blunt abdominal injuries.