Risk factors for early death after abdominal damage control operation / 中华创伤杂志

ABSTRACT

Objective To report the early mortality and associated risk factors after damage control operation (DCO) in patients with severe abdominal trauma.Methods A total of 146 patients hospitalized from January to March in 2015 were retrospectively analyzed.Early death was defined as death occurring within 72 h of first surgery and before the definitive surgery.Based on the death definition, the subjects were divided into death group and survival group.The two groups were compared for gender, age, injury time, injury classification, vital signs, need for cardiopulmonary resuscitation, Glasgow coma score (GCS), injury severity score (ISS), hemoglobin, platelets, prothrombin time (PT), activated partial thromboplastin time (APTT), blood pH, base excess, operative time, and postoperative acute physiology and chronic health evaluation score Ⅱ (APACHE Ⅱ).Logistic regression analysis was applied to examine the predicators of early postoperative mortality.Results There were 118 patients (80.8％) in survival group and 28 patients (19.2％) in death group.Survival and death groups differed significantly with regard to the percent of elderly (6.8％ vs.21.4％), percent of patients with multiple injury (62.7％ vs.85.7％), body temperature [(36.1 ± 0.4) vs.(35.2 ± 0.8) ℃], percent of patients with greater ISS (31.4％ vs.64.3％), PT [(12.1±1.5) vs.(13.9±1.2)s], bloodpH (7.25±0.04vs.7.08±0.11), base excess [(-8.9±2.8) vs.(-10.6±3.3)mmol/L], postoperative APACHE Ⅱ[(12.8 ± 1.8) vs.(17.5 ± 2.0) points] (P ＜ 0.05).Logistic regression analysis identified the age (OR=1.512, 95％ CI 1.112-4.157,P＜0.05), ISS (OR =1.313,95％ CI 1.134-5.442, P ＜ 0.05), APACHE Ⅱ (OR =1.361,95 ％ CI 1.182-5.222, P ＜ 0.05) as the independent risk factors for early mortality.Conclusion The patients underwent DCO for severe abdominal trauma has a high early mortality, which is closely associated with the age, injury severity and postoperative medical status.