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Outcomes following abdominal trauma in Scotland

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Abstract

Purpose

Traumatic abdominal injury is associated with significant mortality, especially in hemodynamically unstable patients. Trauma management now supports more conservative surgical management with judicious non-operative management. The aim of this study is to use STAG data to characterize abdominal trauma outcomes, focusing on factors that may influence mortality.

Methods

A retrospective analysis of prospectively collected STAG data was queried using AIS codes for Scottish abdominal trauma patients between 2011 and 2015. Patients were divided into non-survivor and survivor groups, reflecting mortality. Following this, outcomes and injury patterns of patients undergoing operative or non-operative management were compared between groups.

Results

A total of 1226 were analyzed. The mean age of the cohort was 42.47 ± 19.42 years, with most patients suffering blunt injuries. Non-survivors had more severe injuries to the liver, diaphragm, pancreas, vasculature, and pelvis (p < 0.001, p = 0.005, p = 0.025, p < 0.001, and p < 0.001, respectively). Survivors more often received CT scanning (0.09 [0.03–0.27]) and underwent surgical intervention (57.4% vs 39.7%; p = 0.001). Non-survivors more often had a shorter time till operative intervention (2.6 h vs 6.3 h, p < 0.001).

Conclusions

About 7% of patients in the STAG registry display abdominal injury. Mortality was found to have strong associations with older age, hemodynamic instability, poor neurological status, and head and neck injury. Outcomes may improve with the anticipated creation of the Scottish Trauma System.

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Acknowledgements

Scottish Trauma Audit Group.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

Author information

Authors and Affiliations

  1. R Adams Cowley Shock Trauma Center, University of Maryland Medical System, 22 S. Greene Street, Baltimore, MD, 21201, USA

    Sakib M. Adnan & Jonathan J. Morrison

  2. Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK

    Robert G. Anderson

  3. South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK

    Marta J. Madurska

  4. School of Humanities, University of Strathclyde, Glasgow, UK

    Caitlin J. McNeill

  5. Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, USA

    Jan O. Jansen

Authors
  1. Sakib M. Adnan
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  2. Robert G. Anderson
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  3. Marta J. Madurska
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  4. Caitlin J. McNeill
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  5. Jan O. Jansen
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  6. Jonathan J. Morrison
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Corresponding author

Correspondence to Jonathan J. Morrison.

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Conflict of interest

Sakib M. Adnan, Robert G. Anderson, Marta J. Madurska, Caitlin McNeill, Jan O. Jansen, and Jonathan J. Morrison declare that they have no conflict of interest.

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Adnan, S.M., Anderson, R.G., Madurska, M.J. et al. Outcomes following abdominal trauma in Scotland. Eur J Trauma Emerg Surg 47, 1713–1719 (2021). https://doi.org/10.1007/s00068-019-01146-w

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  • DOI: https://doi.org/10.1007/s00068-019-01146-w

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