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Titolo:
SOLID VISCUS INJURY PREDICTS MAJOR HOLLOW VISCUS INJURY IN BLUNT ABDOMINAL-TRAUMA
Autore:
NANCE ML; PEDEN GW; SHAPIRO MB; KAUDER DR; ROTONDO MF; SCHWAB CW;
Indirizzi:
UNIV PENN,MED CTR,DIV TRAUMA & SURG CRIT CARE,3400 SPRUCE ST PHILADELPHIA PA 19104 UNIV PENN,MED CTR,DIV TRAUMA & SURG CRIT CARE PHILADELPHIA PA 19104 CHILDRENS HOSP PHILADELPHIA,DEPT SURG PHILADELPHIA PA 19104 LANKENAU HOSP,DEPT GEN SURG WYNNEWOOD PA 00000
Titolo Testata:
The journal of trauma, injury, infection, and critical care
fascicolo: 4, volume: 43, anno: 1997,
pagine: 618 - 622
Fonte:
ISI
Lingua:
ENG
Soggetto:
SELECTIVE NONOPERATIVE MANAGEMENT; COMPUTED-TOMOGRAPHY; HEPATIC INJURIES; MULTICENTER EXPERIENCE; SPLENIC TRAUMA; LIVER; CHILDREN; SPLEEN; DIAGNOSIS; ADULTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
21
Recensione:
Indirizzi per estratti:
Citazione:
M.L. Nance et al., "SOLID VISCUS INJURY PREDICTS MAJOR HOLLOW VISCUS INJURY IN BLUNT ABDOMINAL-TRAUMA", The journal of trauma, injury, infection, and critical care, 43(4), 1997, pp. 618-622

Abstract

Background: As nonoperative management of blunt abdominal trauma has become more popular, reliable models for predicting the likelihood of concomitant hollow viscus injury in the hemodynamically stable patientwith a solid viscus injury are increasingly important. Methods: The Pennsylvania Trauma Systems Foundation registry was reviewed for the period from January 1992 to December 1995 for all adult (age > 12 years)patients with blunt trauma and an Abbreviated Injury Scale (AIS) score greater than or equal to 2 for a solid viscus (kidney, liver, pancreas, spleen), Patients with an initial systolic blood pressure < 90 mm Hg were excluded, Hollow viscus injuries included only lacerations or perforations of the gallbladder, gastrointestinal tract, or urinary tract. Results: In the 4-year period, 3,089 patients sustained solid viscus injuries, 296 of whom had a hollow viscus injury (9.6%), The mean age was 35.6 years, mean Injury Severity Score was 22.2, and mean Revised Trauma Score was 7.3; 63.3% of the patients were male, A solitary solid viscus injury occurred in 2,437 patients (79%), 177 of whom (7.3%) had a hollow viscus injury, The frequency of hollow viscus injury increased with the number of solid organs injured: 15.4% of patients with two solid viscus injuries (n = 547) and 34.4% of patients with three solid viscus injuries (n = 96) suffered a concomitant hollow viscus injury (p < 0.001 vs, one organ), A hollow viscus injury was 2.3 timesmore likely for two solid viscus injuries and 6.7 times more likely for three solid viscus injuries compared with a solitary solid viscus injury, For solitary solid viscus injury, the frequency of hollow viscus injury varied little with increasing AIS score (AIS score 2, 6.6%; AIS score 3, 8.2%; AIS score 4, 9.2%; AIS score 5, 6.2%) (p = 0.27 between groups), suggesting that the incidence of hollow viscus injury is related more to the number of solid visceral injuries than the severity of individual organ injury, Also, when the sum of the AIS scores forsolid viscus injuries was < 6, the mean rate of hollow viscus injury was 7.8%, This increased to 22.8% when the sum of the AIS scores for solid viscus injury was greater than or equal to 6 (p < 0.001), A pancreatic injury in combination with any other solid viscus injury had a rate of hollow viscus injury of > 33%. Conclusion: A model of organ injury scaling predicted hollow viscus injury, Multiple solid viscus injuries, particularly pancreatic, or abdominal solid viscus injuries withan AIS score greater than or equal to 6, were predictive of hollow viscus injury, Identification of these injury patterns should prompt consideration for early operative intervention.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 18:53:17