Analysis of Severe Blunt Abdominal Trauma with Solid Organ Injuries in Trauma Patients

嚴重腹部鈍傷患者合併臟器出血之分析

何世偉(Sai-Wai Ho) ； 葉兆斌(Chao-Bin Yeh) ； 陳永福(Ying-Hock Teng) ； 周明智(Ming-Chih Chou) ； 陳智豪(Chih-Hao Chen)

《Journal of Emergency Medicine, Taiwan》 9卷3期 (2007/09) Pp. 72-75

摘要

Objective: Blunt abdominal trauma (BAT) is a major cause of morbidity and mortality among all age groups. The Injury Severity Score (ISS) for predicating the mortality rate and severity of trauma patient injuries has been used worldwide. This study was an analysis of the epidemiology of severe and complex BAT patients with solid organ hemorrhage due to various accidents.
Methods: This was a retrospective study of trauma patients with solid organ hemorrhage and ISS ≥ 9 points who visited a medical center hospital in the central part of Taiwan between January 2005 and December 2006. Age, gender, injury mechanisms, ISS, emergency management and outcome of patients were recorded.
Results: A total of 28 patients qualified for this study. The mean age was 32.5±16.7 years and the mean ISS was 20.8±13.5 points. Solid organ hemorrhage was mainly liver laceration (16 patients, 57.1%) followed by spleen laceration (5 patients, 17.9%). There were 8 patients (28.6%) who had two or more solid organ injuries. Seven of 14 high-grade (grade III-V) liver laceration patients who received transcatheter arterial embolization (TAE) survived without complication. Two patients with grade V injuries died. ISS has a significant relationship to mortality rate (p＜0.01).
Conclusion: Traffic accidents are the most common cause of severe blunt abdominal injury. The majority of solid organ hemorrhage occurs in the liver and it can be confirmed by abdominal CT. TAE is an alternative treatment for patients with high-grade liver lacerations and ISS is a reliable predictor of mortality in these patients.

關鍵字

腹部鈍傷 ； 臟器出血 ； 外傷嚴重度分數ISS

並列摘要

Objective: Blunt abdominal trauma (BAT) is a major cause of morbidity and mortality among all age groups. The Injury Severity Score (ISS) for predicating the mortality rate and severity of trauma patient injuries has been used worldwide. This study was an analysis of the epidemiology of severe and complex BAT patients with solid organ hemorrhage due to various accidents.
Methods: This was a retrospective study of trauma patients with solid organ hemorrhage and ISS ≥ 9 points who visited a medical center hospital in the central part of Taiwan between January 2005 and December 2006. Age, gender, injury mechanisms, ISS, emergency management and outcome of patients were recorded.
Results: A total of 28 patients qualified for this study. The mean age was 32.5±16.7 years and the mean ISS was 20.8±13.5 points. Solid organ hemorrhage was mainly liver laceration (16 patients, 57.1%) followed by spleen laceration (5 patients, 17.9%). There were 8 patients (28.6%) who had two or more solid organ injuries. Seven of 14 high-grade (grade III-V) liver laceration patients who received transcatheter arterial embolization (TAE) survived without complication. Two patients with grade V injuries died. ISS has a significant relationship to mortality rate (p＜0.01).
Conclusion: Traffic accidents are the most common cause of severe blunt abdominal injury. The majority of solid organ hemorrhage occurs in the liver and it can be confirmed by abdominal CT. TAE is an alternative treatment for patients with high-grade liver lacerations and ISS is a reliable predictor of mortality in these patients.

並列關鍵字

blunt abdominal trauma ； solid organ hemorrhage ； Injury Severity Score ISS