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Journal of the Korean Society of Traumatology 2007;20(1):12-18.
Analysis of the Prognostic Factors for Abdominal Trauma
Hee Joon Kim, Hyung Soo Kim, Kyung Won Seo, Jae Kyun Ju, Seong Yeop Ryu, Jeong Cheol Kim, Hyung Rok Kim, Young Kyu Park, Dong Yi Kim, Young Jin Kim, Shin Kon Kim
Department of Surgery, Chonnam National University Medical School, Gwangju, Korea. surgery@jnu.ac.kr
복부외상환자의 예후에 영향을 미치는 인자들에 대한 분석
김희준·김형수·서경원·주재균·류성엽·김정철·김형록·박영규·김동의·김영진·김신곤
전남대학교 의과대학 외과학교실
Abstract
PURPOSE
Recently, trauma is more frequent due to the increases in the population, the number of traffic accident, and the incidence of violence. Especially, abdominal trauma is a leading cause of morbidity and mortality. We analyzed the clinical features and the factors associated with morbidity and mortality.
METHODS
We analyzed 136 patients of abdominal trauma who were admitted at the Department of Surgery, Chonnam National University Hospital, from January 2003 to June 2005. We analyzed the cause of trauma, the injured organ, combined injuries, mental status, blood pressure, laboratory findings, morbidity, and mortality. The relationships between by variable were assesed by using the independent samples test and the Kruskal?Wallis test.
RESULTS
The causes of trauma were traffic accidents (98 cases, 72%), falling accidents (9 cases, 6.6%), violence (6 cases, 4.4%), and stab injuries (6 cases, 4.4%). The injured organs were the small intestines (47 cases, 34.6%), the liver (35 cases, 25.7%), the spleen (26 cases, 19.1%), the mesentery (17 cases, 12.5%), the large intestines (15 cases, 11.0%), the pancreas (14 cases, 10.3%), etc. The most common combined injury was chest injury (53 cases, 39%). Comatose or semicomatose mental status and shock on admission (<60 mmHg in systolic) were related to high mortality (85.7%). In laboratory findings, decreased hemoglobin (<8 g/dL), and platelet count (<50,000/mm3), and increased creatinine level (>1.6 mg/dL) were significant prognostic factors. The incidence of postoperative complications was 40.4%, and frequent complications were wound infection (8.1%) and re-bleeding (8.1%). The overall mortality rate was 18.4%, and most common cause was hypovolemic shock (18 cases, 13.2%), however, there was no statistical difference according to injurd organ.
CONCLUSION
In the multivariate analysis, mental status, hemoglobin, and serum creatinine level were the most significant prognostic factors. When an abdominal trauma patient arrives at the emergency room, a rapid and accurate evaluation of the patient's status and risk factors, and resuscitation, if necessary, have to be performed to lower the morbidity and mortality.
Key Words: Abdominal trauma; Prognostic factor


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