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[Grading and prognosis of blunt abdominal injuries].

F Naess, Arild Nesbakken, J Pillgram-Larsen, T Gerner, K Solheim, J. O. Stadaas

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Abstract

From 1 January 1980 to 31 December 1987, 297 patients were admitted to Ullevål Hospital, Dept. of Surgery, with abdominal injury after blunt trauma. The Injury Severity Score (ISS) was determined in retrospect, and correlated to mortality, morbidity and use of resources. 50 patients (16.8%) died. Mortality increased with increasing ISS, until ISS was above 34. In this group, mortality was 75%. In the survivors, hospital costs (days in the hospital, in the intensive care unit, on mechanical respiration, and number of blood units transfused) increased with increasing ISS. The likelihood of developing septicaemia adult respiratory distress syndrome (ARDS) or multiple organ failure also increased with increasing ISS. Those who died were older and had a higher ISS than the survivors. In patients over 55 years old, the mortality increased significantly. The ISS is well suited for identification of seriously injured patients after blunt abdominal trauma. The ISS can be used to predict mortality, morbidity and cost of treatment in groups of patients.

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What this paper is about

From 1 January 1980 to 31 December 1987, 297 patients were admitted to Ullevål Hospital, Dept. of Surgery, with abdominal injury after blunt trauma. The Injury Severity Score (ISS) was determined in retrospect, and correlated to mortality, morbidity and use of resources. 50 patients (16.8%) died. Mortality increased with increasing ISS, until ISS was above 34. In this group, mortality was 75%. In the survivors, hospital costs (days in the hospital, in the intensive care unit, on mechanical respiration, and number of blood units transfused) increased with increasing ISS. The likelihood of developing septicaemia adult respiratory distress syndrome (ARDS) or multiple organ failure also increased with increasing ISS. Those who died were older and had a higher ISS than the survivors. In patients over 55 years old, the mortality increased significantly. The ISS is well suited for identification of seriously injured patients after blunt abdominal trauma. The ISS can be used to predict mortality, morbidity and cost of treatment in groups of patients.

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Available abstract

From 1 January 1980 to 31 December 1987, 297 patients were admitted to Ullevål Hospital, Dept. of Surgery, with abdominal injury after blunt trauma. The Injury Severity Score (ISS) was determined in retrospect, and correlated to mortality, morbidity and use of resources. 50 patients (16.8%) died. Mortality increased with increasing ISS, until ISS was above 34. In this group, mortality was 75%. In the survivors, hospital costs (days in the hospital, in the intensive care unit, on mechanical respiration, and number of blood units transfused) increased with increasing ISS. The likelihood of developing septicaemia adult respiratory distress syndrome (ARDS) or multiple organ failure also increased with increasing ISS. Those who died were older and had a higher ISS than the survivors. In patients over 55 years old, the mortality increased significantly. The ISS is well suited for identification of seriously injured patients after blunt abdominal trauma. The ISS can be used to predict mortality, morbidity and cost of treatment in groups of patients.

Key concepts: Medicine, ARDS, Blunt, Abdominal trauma, Injury Severity Score, Intensive care unit, Acute respiratory distress, Blunt trauma

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