Mortality Related Factors in Penetrating Abdominal Trauma

Abstract

Abstract Background: Penetrating abdominal trauma is a frequent cause of death in Latinamerica with high rates of morbidity and mortality. A wide variety of therapeutic appraches have been proposed for the manegement of this pathology. In this study, we aimed to analyze the factors related to mortality and to describe outcomes of patients in penetrating abdominal trauma. Methods: Retrospective review of a prospectively collected database was performed. All patients with penetrating abdominal, or thoracoabdominal injury that required urgent laparotomy or laparoscopic exploration between 2018-2020 in our institution were included. Results: A total of 231 patients were included. Male patients were 92.21% and the median age was 28 IQR (22-37). 56.2% patients were ASA I, 19.9% ASA II, 4.7% ASA III, 7.3% ASA IV and 11.6% unknown. 77.5% patients had sstab wounds as penetrating abdmonal trauma etiology and 22.1% by gunshots. 76.2% of the wounds were made in the thoracoabdominal area, 73.8% were abdominal injuries and 24.2% were thoracic. 77.9% of patients presented a PATI score under 25 points. Comorbidities, gunshot wounds, ASA, need of blood product transfusion, number of pRBC needed, surgical approach and organ injury had a statistically significant association ( p<0.05 ) with total mortality and mortalifty after 48 hours. There was also a statistically significant association between comorbidities (OR 407.405 [1.4-118534.05 95% IC]), ASA III (OR 0.004 [0-0.644 95% IC]), and blood product transfusion (OR 0 [0-0.877 95% IC]) with overall mortality. Conclusion: PATI scale appear to be a feasible tool to predict worst outcomes in abdominal penetrating trauma patients. Residents as first surgeons showed no evidence of a higher complications rate.