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ID 49104
file
creator
Oshita, Ko
Nakahara, Hideki
Oshita, Akihiko
Matsugu, Yasuhiro
Urushihara, Takashi
Itamoto, Toshiyuki
subject
Abdominal trauma
damage control surgery
lethal triad
trauma and injury severity score
abstract
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.
journal title
Hiroshima Journal of Medical Sciences
volume
Volume 69
issue
Issue 1
start page
9
end page
14
date of issued
2020-03
publisher
Hiroshima University Medical Press
issn
0018-2052
2433-7668
ncid
publisher doi
language
eng
nii type
Departmental Bulletin Paper
HU type
Departmental Bulletin Papers
DCMI type
text
format
application/pdf
text version
publisher
rights
Copyright (c) 2020 Hiroshima University Medical Press
relation url
department
Graduate School of Biomedical & Health Sciences
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