Intra-abdominal injury following blunt trauma becomes clinically apparent within 9 hours

Edward L. Jones, Robert T. Stovall, Teresa S. Jones, Denis D. Bensard, Clay Cothren Burlew, Jeffrey L. Johnson, Gregory Jurkovich, Carlton C. Barnett, Frederic M. Pieracci, Walter L. Biffl, Ernest E. Moore

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Background: The diagnosis of blunt abdominal trauma can be challenging and resource intensive. Observation with serial clinical assessments plays a major role in the evaluation of these patients, but the time required for intra-abdominal injury to become clinically apparent is unknown. The purpose of this study was to determine the amount of time required for an intra-abdominal injury to become clinically apparent after blunt abdominal trauma via physical examination or commonly followed clinical values. Methods: A retrospective review of patients who sustained blunt trauma resulting in intra-abdominal injury between June 2010 and June 2012 at a Level 1 academic trauma center was performed. Patient demographics, injuries, and the amount of time from emergency department admission to sign or symptom development and subsequent diagnosis were recorded. All diagnoses were made by computed tomography or at the time of surgery. Patient transfers from other hospitals were excluded. Results: Of 3,574 blunt trauma patients admitted to the hospital, 285 (8%) experienced intra-abdominal injuries. The mean (SD) age was 36 (17) years, the majority were male (194 patients, 68%) and the mean (SD) Injury Severity Score (ISS) was 21 (14). The mean (SD) time from admission to diagnosis via computed tomography or surgery was 74 (55) minutes. Eighty patients (28%) required either surgery (78 patients, 17%) or radiographic embolization (2 patients, 0.7%) for their injury. All patients who required intervention demonstrated a sign or symptom of their intra-abdominal injury within 60 minutes of arrival, although two patients were intervened upon in a delayed fashion. All patients with a blunt intra-abdominal injury manifested a clinical sign or symptom of their intra-abdominal injury, resulting in their diagnosis within 8 hours 25 minutes of arrival to the hospital. Conclusion: All diagnosed intra-abdominal injuries from blunt trauma manifested clinical signs or symptoms that could prompt imaging or intervention, leading to their diagnosis within 8 hours 25 minutes of arrival to the hospital. All patients who required an intervention for their injury manifested a sign or symptom of their injury within 60 minutes of arrival. LEVEL OF EVIDENCE: Therapeutic study, level IV. Epidemiologic study, level III.

Original languageEnglish (US)
Pages (from-to)1020-1023
Number of pages4
JournalJournal of Trauma and Acute Care Surgery
Volume76
Issue number4
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Keywords

  • 60 minutes
  • 8 hours
  • Blunt trauma
  • clinically apparent
  • intra-abdominal injury

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Fingerprint Dive into the research topics of 'Intra-abdominal injury following blunt trauma becomes clinically apparent within 9 hours'. Together they form a unique fingerprint.

  • Cite this

    Jones, E. L., Stovall, R. T., Jones, T. S., Bensard, D. D., Burlew, C. C., Johnson, J. L., Jurkovich, G., Barnett, C. C., Pieracci, F. M., Biffl, W. L., & Moore, E. E. (2014). Intra-abdominal injury following blunt trauma becomes clinically apparent within 9 hours. Journal of Trauma and Acute Care Surgery, 76(4), 1020-1023. https://doi.org/10.1097/TA.0000000000000131