Factors affecting outcome in penetrating oesophageal trauma.
BACKGROUND
Penetrating oesophageal trauma is rare and the risk factors affecting outcome have not been clearly identified. Delayed management has been cited as a factor contributing to the high rates of morbidity and mortality, but evidence for this is lacking.


METHODS
A retrospective study was undertaken of patients with penetrating oesophageal trauma presenting to a level I trauma centre over 8 years. Outcome was assessed in terms of mortality, morbidity (oesophageal and non-oesophageal), and length of hospital and intensive care unit (ICU) stays.


RESULTS
Fifty-two patients with oesophageal injury who reached the operating theatre were included. The overall mortality rate was 6 per cent. Fifteen patients (29 per cent) developed oesophageal injury-related complications. Time from injury to management was the only important risk factor for the development of oesophageal complications (P = 0.001), but did not affect the length of ICU (P = 0.560) or hospital (P = 0.329) stay, incidence of non-oesophageal injury-related complications (P = 0.963) or death (P = 0.937). Patients with gunshot injuries spent longer in the ICU (P = 0.007) and the duration of hospital stay was longer for those with higher-grade oesophageal injuries (P = 0.025).


CONCLUSIONS
The risk of oesophageal injury-related complications was directly related to the interval between the trauma and definitive management of the oesophageal injury.
Smakman
N
N
Department of Surgery, Trauma Unit, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Nicol
A J
AJ
Walther
G
G
Brooks
A
A
Navsaria
P H
PH
Zellweger
R
R
D000293:Adolescent; D000328:Adult; D003422:Critical Care; D004947:Esophagus / Q000293:injuries*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013524:Surgical Flaps; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000601:surgery*