Outcomes of Damage Control Surgery for Abdominal Trauma Evaluated Using the Trauma and Injury Severity Score and Lethal Triad in a Single Institution

Oshita Ko

Nakahara Hideki

Oshita Akihiko

Matsugu Yasuhiro

Urushihara Takashi

Itamoto Toshiyuki

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

In trauma management, damage control surgery is an effective approach to decrease the incidence of preventable trauma death. In this study, we aimed to investigate the survival outcomes and clinical factors in patients undergoing damage control surgery for severe abdominal trauma, in relation to trauma severity based on the trauma and injury severity score and lethal triad (hypothermia, metabolic acidosis, and coagulopathy), to assess the indicators of mortality and criteria for performing damage control surgery. Fifteen patients with severe abdominal trauma underwent damage control surgery from January 2011 to September 2017. We compared the short-term outcomes and perioperative factors associated with the trauma and injury severity score and the lethal triad between survivors and non-survivors. Of the 15 included patients, eight (53.3%) survived and seven (46.7%) died. No preventable deaths occurred. The patient characteristics, including age, sex, and mechanism of injury were not related to survival. The injury severity score (p = 0.035) and abbreviated injury scale score of the head (p = 0.005) were significantly higher among the nonsurvivors than among the survivors. Of the lethal triad, the incidence of metabolic acidosis was significantly higher in the non-survivors (p < 0.050). This study found that head injury and metabolic acidosis are predictors of mortality. These indications provide a practical basis for determining whether to use damage control surgery and postoperative management.

Abdominal trauma

damage control surgery

lethal triad

trauma and injury severity score

英語

Hiroshima University Medical Press

Copyright (c) 2020 Hiroshima University Medical Press

[ISSN] 0018-2052

[ISSN] 2433-7668

[NCID] AA00664312

[DOI] 10.24811/hjms.69.1_9

[DOI] https://doi.org/10.24811/hjms.69.1_9