Risk indicators of morbidity and mortality in abdominal injuries

Abstract

To establish the risk factors for morbidity and mortality in patients with abdominal injuries. DESIGN: A descriptive, prospective, hospital-based study. SETTING: The adult general surgical wards of Kenyatta National Hospital (KNH), a tertiary Teaching and Referral Hospital in Nairobi, Kenya from November 2004 to February 2005. SUBJECTS: Eighty consecutive admissions of adult patients with either blunt or penetrating abdominal injuries. MAIN OUTCOME MEASURES: Demographic data, type and cause of injury, degree of injury, vital signs at the time of admission, duration prior to admission, instituted intervention as to whether treated conservatively or operatively, duration prior to surgery, complications, admission to Intensive Care Unit (ICU), blood transfusion and mortality. RESULTS: Complications and mortality were predominantly in males and those in the age bracket 40 years and below. Penetrating abdominal injuries had higher rates of complications while blunt abdominal injuries had greater mortality. The independent indicators of morbidity and mortality in abdominal injuries were type of injury, cause of injury, degree of injury and the physiological state of patient at admission. Multivariate analysis showed age, duration prior to admission, surgery, duration prior to surgery, blood transfusion and admission to ICU as indirect predictors of morbidity and mortality. CONCLUSION: The greatest determinants of morbidity and mortality in abdominal injuries are the degree of injury and the physiological state of patient at admission. The rest of the indicators are interplays of these two factors.