Annali italiani di chirurgia
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Comparative Study
The epidemiology and clinical evaluation of abdominal trauma. An analysis of a multidisciplinary trauma registry.
Abdominal trauma is present in 7-10% of all trauma victims, and in cases of severe trauma is often found together with orthopedic, thoracic or central nervous system (CNS) injuries. The aim of the present study was to perform a comparative analysis of abdominal trauma and trauma involving other body regions, evaluating the prognostic significance of abdominal injuries in patients with severe trauma, based on data from a multidisciplinary trauma registry. Data from the period from March 1 2006 to December 31 2007 was collected from the trauma registry of the University Hospital Sant'Andrea in Rome, Italy. ⋯ Overall mortality among liver trauma patients was 24.2% (8 patients) with an average liver AIS of 3.2 +/- 0.3 (died vs. survived p < 0.05). In multivariate analysis, among the general population of trauma patients, the ISS (p < 0.001), patient age (p < 0.003), and an orthopedic (p < 0.002) or CNS injury (p < 0.006) proved to be significant independent predictors of the presence of an abdominal injury. Multivariate analysis showed that in patients with abdominal trauma, only the ISS (p < 0.001) was a significant independent predictor of mortality.
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The purpose of this paper is to present the most recent revision of diagnostic therapeutic protocols regarding polytrauma that are operational in the Trauma Center of Cesena, and to check what impact the progressive implementation and review of these algorithms has had on predefined indicators of results and utilization of diagnostic and therapeutic resources. Finally for the purpose of comparing the results obtained in a subgroup of patients treated in the Trauma Center of Cesena, with those obtained in a group homogeneous for ISS and year of hospitalization stored in the RRGT (Registro Regionale Grandi Traumi - Regional Major Trauma Registry). ⋯ The hemodynamic response of patients after primary assessment determines the subsequent diagnostic and therapeutic procedures. The protocols that we utilized had a positive impact on the mortality of patients hospitalized in the intensive care and on the average intensive care stay, and were also associated with an increase in the number of angiography and arterial embolizations performed in sicker patients and those with relevant surgical lesions. The decrease in mortality is also observed in comparison with the RRGT data. We believe therefore that these protocols can provide a valuable and effective aid for those involved in the care of trauma victims, allowing them to always be able to quickly decide what to do, when to do, how to do, and where to do what needs to be done.