ASSOCIATION OF PATIENT DEMOGRAPHICS AND INJURY CHARACTERISTICS WITH OUTCOMES OF ISOLATED ABDOMINAL TRAUMA CASES UNDERGOING EXPLORATORY LAPAROTOMY AT A TERTIARY CARE HOSPITAL

Background and aim: Abdominal trauma caused by both accidental (motor vehicle collision/road traffic accident) and non-accidental (firearm injury/sharp object penetration) injury is a common cause of patients presenting to the emergency room and undergoing subsequent exploratory surgery. Our aim was to classify patients based on both modifiable (co-morbidities) and non-modifiable (age, sex etc.) characteristics, type and mechanism of injuries and organs affected to evaluate the extent of relationship with outcomes of surgically managed abdominal trauma.

Results: A total of 323 patients who presented from 2014 to 2021 were included in the study, with 209 male (64.7%) and 114 female (35.3%) patients. The sample included patients from the age of 12 to 71 with a mean of 40.1. The majority of patients presented with blunt abdominal trauma 171 (52.9%) followed closely by penetrating injuries 152 (47%). Motor vehicle collision was the leading cause of injuries in 171 (52.9 %) patients, followed by firearm injuries 114 (35.2%) patients, and the least number of patients presenting due to sharp object penetrating injuries 38 (11.7%). The common associated co-morbidities were diabetes 76 (23.5%) and hypertension 57 (17.6 %). The most commonly affected organs were spleen in 152 (47 %) patients, followed by small bowel in 133 (41.1%) patients, and other organs (including liver, stomach, kidneys, colon and pancreas) in 38 (11.7%) patients. More than half of patients 171 (52.9%) recovered without any complications. The overall mortality rate was 38 (11.7 %). The most common post-operative complications were shock in 57 (17.6%) patients, surgical site infections (SSI) in 38 (11.7%) patients, and others (adhesions/ paralytic ileus/urinary tract infection/ sepsis etc.) in 19 (5.8 %) patients. 133 out of the 171 cases of motor vehicle collisions (77.7%) were reportedly not wearing a seatbelt.

Conclusions: We observed blunt injuries from motor vehicle collisions to be the leading cases of abdominal trauma in the emergency room requiring surgery. The most commonly affected organ was the spleen followed by small bowel. The most common complication was shock due to intra-peritoneal bleeding followed by surgical site infections. Moreover, most patients reported not wearing a seatbelt during the motor vehicle collision.

Key words: Abdominal trauma, exploratory laparotomy, age, sex, comorbidity, cause, mechanism.