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Contemporary characteristics of blunt abdominal trauma in a regional series from the UK

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posted on 25.10.2016, 09:14 by R. Pande, Athanasios Saratzis, J. Winter Beatty, C. Doran, R. Kirby, C. Harmston
INTRODUCTION: Blunt abdominal trauma (BAT) is a common injury in recent trauma series. The characteristics of patients with BAT have changed following the reconfiguration of UK trauma services. The aim of this study was to build a new profile for BAT patients undergoing immediate or delayed laparotomy. METHODS: All 5,401 consecutive adults presenting with major trauma between April 2012 and April 2014 in the 3 major trauma centres in the West Midlands were analysed to identify all patients with BAT. A total of 2,793 patients with a mechanism of injury or symptomatology consistent with BAT were identified (52%). Outcomes were analysed using local electronic clinical results systems and notes. RESULTS: Of the 2,793 patients, 179 (6.4%) had a mesenteric or hollow viscus injury, 168 (6.0%) had a hepatobiliary injury, 149 (5.4%) had a splenic injury and 46 (1.6%) had a vascular injury. Overall, 103 patients (3.7%) underwent an early (<12 hours) laparotomy while 30 (1.1%) underwent a delayed (>12 hours) laparotomy. Twenty (66.7%) of those undergoing a delayed laparotomy had a hollow viscus injury. In total, 170 deaths occurred among the BAT patients (6.1%). In the early laparotomy group, 53 patients died (51.5%) whereas in the delayed laparotomy group, 6 patients died (20.0%). CONCLUSIONS: This series has attempted to provide the characteristics of patients with BAT in a large contemporary UK cohort. BAT was found to be a common type of injury. Early and delayed laparotomy occurred in 3.7% and 1.1% of these patients respectively, mostly because of hollow viscus injury in both cases. Outcomes were comparable with those in the international literature from regions with mature trauma services.

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Citation

Annals of the Royal College of Surgeons of England, 2017, 99 (1), pp. 82-87

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences

Version

VoR (Version of Record)

Published in

Annals of the Royal College of Surgeons of England

Publisher

Royal College of Surgeons of England

issn

0035-8843

eissn

1478-7083

Acceptance date

16/04/2016

Copyright date

2016

Available date

04/08/2017

Publisher version

http://publishing.rcseng.ac.uk/doi/10.1308/rcsann.2016.0223

Notes

The file associated with this record is under a 12 month embargo from publication in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.

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en

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