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Self-Inflicted Abdominal Stab Wounds Have a Higher Rate of Non-therapeutic Laparotomy/Laparoscopy and a Lower Risk of Injury

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Abstract

Background

The profile and management of self-inflicted abdominal stab wounds (SI-ASW) patients is still obscure.

Methods

The National Trauma Data Bank (2012) was queried for adults with abdominal stab wounds (n = 9544). Patients with SI-ASW (n = 1724) and non-SI-ASW (n = 7820) were compared. Predictors for non-therapeutic laparotomy/laparoscopy (non-TL) in SI-ASW patients were identified.

Results

SI-ASW patients were older, had more females and behavioral disorders, similar physiology, but a lower Injury Severity Score. They had more laparotomies overall (54 versus 48%, p < 0.0001) and more non-TL (42 versus 32%, p < 0.0001), but less injuries (43 versus 53%, p < 0.0001), although peritoneal violation rate was similar. Complications and mortality were similar. In the SI-ASW cohort, non-TL patients were more likely to be female and younger, and to have Glasgow Coma Scale (GCS) ≥13 and a higher systolic blood pressure. History of psychiatric, drug and alcohol disorders was associated with SI-ASW, but did not independently predict the need for treatment in adjusted models.

Conclusion

Patients with SI-ASW underwent more non-TL than patients with non-SI-ASW. Female gender, younger age, and a higher GCS and systolic blood pressure predicted non-TL in this group.

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Acknowledgements

This manuscript was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, Award UL1TR001064.

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Authors and Affiliations

  1. Division of Trauma and Acute Care Surgery, Tufts Medical Center, Tufts University School of Medicine, 800 Washington st, #4488, Boston, MA, 02111, USA

    Nikolay Bugaev, Sandra S. Arabian & Reuven Rabinovici

  2. Tufts University School of Medicine, 800 Washington st, #4488, Boston, MA, 02111, USA

    Kevin McKay

  3. Tufts Clinical and Translational Science Institute, Tufts University, 800 Washington st, #63, Boston, MA, 02111, USA

    Janis L. Breeze

  4. Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington st, #63, Boston, MA, 02111, USA

    Janis L. Breeze

Authors
  1. Nikolay Bugaev
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  2. Kevin McKay
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  3. Janis L. Breeze
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  4. Sandra S. Arabian
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  5. Reuven Rabinovici
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Correspondence to Nikolay Bugaev.

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Bugaev, N., McKay, K., Breeze, J.L. et al. Self-Inflicted Abdominal Stab Wounds Have a Higher Rate of Non-therapeutic Laparotomy/Laparoscopy and a Lower Risk of Injury. World J Surg 41, 2681–2688 (2017). https://doi.org/10.1007/s00268-017-4083-7

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  • DOI: https://doi.org/10.1007/s00268-017-4083-7

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