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How long of a postponement in surgery can a blunt hollow viscus injury patient tolerate? A retrospective study from the National Trauma Data Bank
- Source :
- Surgery. 171(2)
- Publication Year :
- 2021
-
Abstract
- Background In the management of patients with blunt abdominal trauma, delayed diagnosis and treatment of hollow viscus injury can occur. We assessed the effect of the time to surgery on the outcomes of blunt hollow viscus injury patients. Methods The National Trauma Data Bank was queried from 2012 to 2015 to identify patients with blunt hollow viscus injury for inclusion. Patients with unstable hemodynamics, concomitant intra-abdominal organ injuries, or other severe extra-abdominal injuries were excluded. Inverse probability of treatment weighting and multivariate logistic regression were used to evaluate the effect of the time to surgery on the outcomes. Results In total, 2,997 patients with blunt hollow viscus injury were studied; the mean time to abdominal surgery was 6.7 hours. Twenty-two hours was selected as a cutoff value for further analyses because of an observed transition zone at that time in the distribution of mortality and severe sepsis rates. After adjustment, patients who underwent surgery within 22 hours had a significantly lower mortality rate (1.2% vs 4.2%), lower sepsis rate (0.9% vs 4.5%), shorter hospital length of stay (8.7 vs 12.0 days), and shorter intensive care unit length of stay (1.4 vs 3.3 days). In patients who underwent surgery within 22 hours, neither mortality nor sepsis were affected significantly by the time to surgery. Conclusion In the management of patients with blunt hollow viscus injury, early surgical treatment is needed. Patients with isolated blunt hollow viscus injury may have a poor outcome if they undergo abdominal surgery more than 22 hours after arrival in the emergency department.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Databases, Factual
Abdominal Injuries
Wounds, Nonpenetrating
law.invention
Time-to-Treatment
Sepsis
Young Adult
Blunt
Injury Severity Score
law
medicine
Hollow viscus
Humans
Child
Retrospective Studies
business.industry
Retrospective cohort study
Emergency department
Middle Aged
medicine.disease
Intensive care unit
Surgery
Treatment Outcome
Abdominal trauma
Surgical Procedures, Operative
Female
business
Abdominal surgery
Subjects
Details
- ISSN :
- 15327361
- Volume :
- 171
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Surgery
- Accession number :
- edsair.doi.dedup.....dc72660498bd9bc18570769b4cbfd03b