Comparison of Clinical Characteristics, Therapy, and Short-Term Prognosis between Blunt and Penetrating Abdominal Trauma: A Multicentric Retrospective Cohort Study
Objective. Large-scale studies on the characteristics and management of abdominal trauma in megacities in China are lacking. The aim of this study was to analyze and present the clinical patterns and treatment status of abdominal trauma in regional medical centers. Methods. Cases of abdominal trauma...
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Wiley
2024-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2024/5215977 |
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| author | Yi Liu Yunhe Gao Zhida Chen Jianxin Cui Wenquan Liang Ze Wang Linde Sun Chuan Pang Yuan Lv Guoxiao Liu Tingting Lu Gan Zhang Xiaoyu Dong Hong Xu Sheng Yao Feng Liang Gang Liu Gang Chen Jianmiao He Wentong Xu Bo Wei Hongqing Xi Lin Chen |
| author_facet | Yi Liu Yunhe Gao Zhida Chen Jianxin Cui Wenquan Liang Ze Wang Linde Sun Chuan Pang Yuan Lv Guoxiao Liu Tingting Lu Gan Zhang Xiaoyu Dong Hong Xu Sheng Yao Feng Liang Gang Liu Gang Chen Jianmiao He Wentong Xu Bo Wei Hongqing Xi Lin Chen |
| author_sort | Yi Liu |
| collection | DOAJ |
| description | Objective. Large-scale studies on the characteristics and management of abdominal trauma in megacities in China are lacking. The aim of this study was to analyze and present the clinical patterns and treatment status of abdominal trauma in regional medical centers. Methods. Cases of abdominal trauma treated at seven medical centers in Beijing from 2010 to 2021 were collected. Clinical information about age, sex, injury cause, geographic distribution, abbreviated injury scale/injury severity score (AIS/ISS) value, injury-hospital time, preoperative time, surgically identified organ injuries, type of surgery, causes of reoperation and 90-day mortality was included in this study. Clinical characteristics, treatment methods, and short-term prognoses (90-days survival) were compared between blunt abdominal trauma (BAT) and penetrating abdominal trauma (PAT) cases. Non-normally distributed data are described as medians (IQR), and the Mann‒Whitney U test was performed; qualitative data were analyzed using the X2 test. Univariate and multivariate survival analyses were performed by the Cox proportional hazards model. Results. A total of 553 patients (86.98% male) with a median age of 36.50 (27.00–48.00) years were included. The BAT group had a significantly higher proportion of serious injury (P=0.001), lower initial hemoglobin level (P=0.001), and a lower laparoscopy surgery rate (P=0.044) compared to the PAT group. Additionally, more BAT cases were from the area around Beijing (P=0.008) and a longer injury-regional hospital time (10.47 (5.18–22.51) hours vs. 7.00 (3.80–15.38) hours, P=0.001). In the hollow viscus injury subgroup, the BAT group had a significantly longer injury-regional hospital time and preoperative time compared to the PAT group (injury-regional hospital time: 10.23 (6.00–21.59) hours vs. 7.07 (3.99–13.85) hours, P=0.002; preoperative time: 3.02 (2.01–5.58) hours vs. 2.81 (1.85–3.63) hours, P=0.047). The overall 90-day mortality was 11.9%, and longer injury-regional hospital time (HR: 1.01, 95% CI: 1.00–1.02, P=0.008), receipt of ICU treatment (HR: 4.69, 95% CI: 2.54–8.65, P=0.001), and severe ISSs (ISS > 25 vs. ISS < 16, HR: 2.78, 95% CI: 1.38–5.601, P=0.004) had a worse impact on survival. Conclusion. More patients with BAT were transferred to higher-level hospital, leading to significantly longer prehospital and preoperation time. In the subgroup of hemodynamically stable individuals, more patients with BAT experienced hollow viscus injuries. For those patients, aggressive diagnostic laparoscopic exploration may be beneficial. Patients with longer injury-regional hospital intervals, the need for ICU care, and higher injury severity scores (ISSs) suffered from worse prognoses. |
| format | Article |
| id | doaj-art-cec8630746d541efbda399965a2e8bf0 |
| institution | OA Journals |
| issn | 2090-2859 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-cec8630746d541efbda399965a2e8bf02025-08-20T02:19:30ZengWileyEmergency Medicine International2090-28592024-01-01202410.1155/2024/5215977Comparison of Clinical Characteristics, Therapy, and Short-Term Prognosis between Blunt and Penetrating Abdominal Trauma: A Multicentric Retrospective Cohort StudyYi Liu0Yunhe Gao1Zhida Chen2Jianxin Cui3Wenquan Liang4Ze Wang5Linde Sun6Chuan Pang7Yuan Lv8Guoxiao Liu9Tingting Lu10Gan Zhang11Xiaoyu Dong12Hong Xu13Sheng Yao14Feng Liang15Gang Liu16Gang Chen17Jianmiao He18Wentong Xu19Bo Wei20Hongqing Xi21Lin Chen22Department of Abdominal Trauma SurgeryDepartment of Gastric SurgeryResearch Institute of General SurgeryDepartment of Abdominal Trauma SurgeryDepartment of Gastric SurgeryDepartment of Abdominal Trauma SurgeryDepartment of Abdominal Trauma SurgeryDepartment of General SurgeryDepartment of General SurgeryDepartment of Abdominal Trauma SurgeryResearch Institute of General SurgeryResearch Institute of General SurgeryResearch Institute of General SurgeryDepartment of General SurgeryDepartment of General SurgeryDepartment of General SurgeryDepartment of General SurgeryDepartment of General SurgeryDepartment of General SurgeryDepartment of Abdominal Trauma SurgeryDepartment of Abdominal Trauma SurgeryDepartment of Abdominal Trauma SurgeryDepartment of Abdominal Trauma SurgeryObjective. Large-scale studies on the characteristics and management of abdominal trauma in megacities in China are lacking. The aim of this study was to analyze and present the clinical patterns and treatment status of abdominal trauma in regional medical centers. Methods. Cases of abdominal trauma treated at seven medical centers in Beijing from 2010 to 2021 were collected. Clinical information about age, sex, injury cause, geographic distribution, abbreviated injury scale/injury severity score (AIS/ISS) value, injury-hospital time, preoperative time, surgically identified organ injuries, type of surgery, causes of reoperation and 90-day mortality was included in this study. Clinical characteristics, treatment methods, and short-term prognoses (90-days survival) were compared between blunt abdominal trauma (BAT) and penetrating abdominal trauma (PAT) cases. Non-normally distributed data are described as medians (IQR), and the Mann‒Whitney U test was performed; qualitative data were analyzed using the X2 test. Univariate and multivariate survival analyses were performed by the Cox proportional hazards model. Results. A total of 553 patients (86.98% male) with a median age of 36.50 (27.00–48.00) years were included. The BAT group had a significantly higher proportion of serious injury (P=0.001), lower initial hemoglobin level (P=0.001), and a lower laparoscopy surgery rate (P=0.044) compared to the PAT group. Additionally, more BAT cases were from the area around Beijing (P=0.008) and a longer injury-regional hospital time (10.47 (5.18–22.51) hours vs. 7.00 (3.80–15.38) hours, P=0.001). In the hollow viscus injury subgroup, the BAT group had a significantly longer injury-regional hospital time and preoperative time compared to the PAT group (injury-regional hospital time: 10.23 (6.00–21.59) hours vs. 7.07 (3.99–13.85) hours, P=0.002; preoperative time: 3.02 (2.01–5.58) hours vs. 2.81 (1.85–3.63) hours, P=0.047). The overall 90-day mortality was 11.9%, and longer injury-regional hospital time (HR: 1.01, 95% CI: 1.00–1.02, P=0.008), receipt of ICU treatment (HR: 4.69, 95% CI: 2.54–8.65, P=0.001), and severe ISSs (ISS > 25 vs. ISS < 16, HR: 2.78, 95% CI: 1.38–5.601, P=0.004) had a worse impact on survival. Conclusion. More patients with BAT were transferred to higher-level hospital, leading to significantly longer prehospital and preoperation time. In the subgroup of hemodynamically stable individuals, more patients with BAT experienced hollow viscus injuries. For those patients, aggressive diagnostic laparoscopic exploration may be beneficial. Patients with longer injury-regional hospital intervals, the need for ICU care, and higher injury severity scores (ISSs) suffered from worse prognoses.http://dx.doi.org/10.1155/2024/5215977 |
| spellingShingle | Yi Liu Yunhe Gao Zhida Chen Jianxin Cui Wenquan Liang Ze Wang Linde Sun Chuan Pang Yuan Lv Guoxiao Liu Tingting Lu Gan Zhang Xiaoyu Dong Hong Xu Sheng Yao Feng Liang Gang Liu Gang Chen Jianmiao He Wentong Xu Bo Wei Hongqing Xi Lin Chen Comparison of Clinical Characteristics, Therapy, and Short-Term Prognosis between Blunt and Penetrating Abdominal Trauma: A Multicentric Retrospective Cohort Study Emergency Medicine International |
| title | Comparison of Clinical Characteristics, Therapy, and Short-Term Prognosis between Blunt and Penetrating Abdominal Trauma: A Multicentric Retrospective Cohort Study |
| title_full | Comparison of Clinical Characteristics, Therapy, and Short-Term Prognosis between Blunt and Penetrating Abdominal Trauma: A Multicentric Retrospective Cohort Study |
| title_fullStr | Comparison of Clinical Characteristics, Therapy, and Short-Term Prognosis between Blunt and Penetrating Abdominal Trauma: A Multicentric Retrospective Cohort Study |
| title_full_unstemmed | Comparison of Clinical Characteristics, Therapy, and Short-Term Prognosis between Blunt and Penetrating Abdominal Trauma: A Multicentric Retrospective Cohort Study |
| title_short | Comparison of Clinical Characteristics, Therapy, and Short-Term Prognosis between Blunt and Penetrating Abdominal Trauma: A Multicentric Retrospective Cohort Study |
| title_sort | comparison of clinical characteristics therapy and short term prognosis between blunt and penetrating abdominal trauma a multicentric retrospective cohort study |
| url | http://dx.doi.org/10.1155/2024/5215977 |
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