Indicative factors for surgical or angiographic intervention in hemodynamically stable patients with blunt abdominal trauma: A retrospective cohort study

The standard of care for intraperitoneal injury in hemodynamically stable patients after blunt abdominal trauma has been replaced by non-operative management (NOM). However, selective NOM, depending on the situation, seems necessary in determining the treatment plan. In this study, we attempted to i...

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Bibliographic Details
Published in:Journal of visceral surgery 2023-02, Vol.160 (1), p.12-18
Main Authors: Chung, J.S., Jang, S.W., Jung, P.Y., Kim, M.J., Choi, Y.U., Bae, K.S., Kim, S.
Format: Article
Language:English
Subjects:
Abdominal Injuries - diagnostic imaging
Abdominal Injuries - surgery
Abdominal trauma
Adult
Conservative management
Delta neutrophil index
Humans
Lactate level
Retrospective Studies
Risk Factors
Surgical or angiographic intervention
Trauma Centers
Wounds, Nonpenetrating - diagnostic imaging
Wounds, Nonpenetrating - surgery
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Summary:The standard of care for intraperitoneal injury in hemodynamically stable patients after blunt abdominal trauma has been replaced by non-operative management (NOM). However, selective NOM, depending on the situation, seems necessary in determining the treatment plan. In this study, we attempted to identify risk factors for surgical or angiographic intervention (SAI) in hemodynamically stable blunt abdominal trauma patients. This retrospective study which included adult patients who were brought to a regional trauma center was conducted from March 2015 to October 2019. We evaluated the characteristics of blunt abdominal trauma patients and analyzed factors that were related to the requirement of SAI in these patients. Patients were divided into SAI and conservative management (CM) groups. We reviewed 1,176 patients, and after exclusions, of whom 248 blunt abdominal trauma and free fluid observed on CT were identified. The mean pulse rate was higher in the SAI than in the CM (P=0.025). Laboratory findings showed that lactate and delta neutrophil index (DNI) levels were higher in the SAI than in the CM (P=0.002 and 0.026 respectively). Additionally, the mean free fluid size in the SAI (85.69mm) was significantly larger than that in the CM (68.12mm; P=0.001), and blush was more frequently observed in the SAI (P
ISSN:1878-7886
1878-7886
DOI:10.1016/j.jviscsurg.2022.01.007