The prognostic factors and the prognostic values of trauma scoring systems in patients treated surgically after blunt abdominal trauma

ABSTRACTTHE PROGNOSTIC FACTORS AND THE PROGNOSTIC VALUES OF TRAUMASCORING SYSTEMS IN PATIENTS TREATED SURGICALLY AFTER BLUNTABDOMINAL TRAUMAThe aim of this study was determining the prognostic factors in patients treatedsurgically after blunt abdominal trauma and evaluating the prognostic values of traumascoring systems.This study performed in Çukurova University General Surgery Department. Of the151 blunt abdominal trauma patients admitted and had laparotomy during 1st January 1998and 31st December 2005 were reviewed retrospectively. Data about age, sex, vital signs,physical findings, laboratory findings, severity of injury, affected organ, injury pattern, timeinterval between surgery and operation, presence of complications and blood transfusion wasrecorded for all patients. Trauma and injury severity score (TRISS), Acute Physiology andChronic Health Evaluation II (APACHE II), Injury severity score (ISS), Trauma score (TS),Revised trauma score (RTS), CRAMS and Glasgow coma scale (GCS) scores were calculatedfor all patients and compared as predictors of patient outcomes.Mean age was 36.5, with F/M ratio of 1/ 2.6. The most common pattern of trauma wastraffic accident injuries (73.4 %) with the spleen being the most affected organ (36.5 %).Major surgical complication developed in 54 (34.8 %) patients postoperatively and 37 (24.5%) patients died. The accuracy rate of Trauma and injury severity score, Acute Physiologyand Chronic Health Evaluation II, Injury severity score, Revised trauma score, Trauma score,CRAMS and Glasgow coma scale to predict the patient outcomes was found as 92 %, 87 %,80 %, 72 %, 69 %, 68 % and 66 %, respectively.Among patients with blunt abdominal trauma treated surgically, Trauma and injuryseverity score and Acute Physiology and Chronic Health Evaluation II were found to be thebest systems in prediction of patient outcomes, while age over 55, transfusion over 6 units,the time interval of more than 12 hours between trauma and operation and the development ofpostoperative compications were determined as independent prognostic factors.Key Words: Blunt abdominal trauma, trauma scoring system, prognostic factors.