Intraabdominal injury is common in blunt trauma patients who sustain spinal cord injury.
The evaluation of the abdomen in patients with spinal cord injury (SCI) is challenging for obvious reasons. There are very little data on the incidence and complications of patients who sustain SCI with concomitant intraabdominal injury (IAI). To determine the incidence and outcomes of IAI in blunt trauma patients with SCI, a trauma registry and record review was performed between January 1998 and December 2005. Baseline demographic data, Injury Severity Score, and associated IAI were collected. Two groups were established and outcomes were analyzed based on the presence or absence of IAI. Intraabdominal and hollow viscus injures were found in 15 per cent and 6 per cent, respectively, of 292 patients with blunt SCI. The presence of intraabdominal injury varied according to the level of the SCI: 10 per cent of cervical, 23 per cent of thoracic, and 18 per cent of lumbar SCI. The overall mortality was 16 per cent. The presence of intraabdominal injury was associated with longer intensive care unit length of stay (13 versus 6 days, P < 0.01), hospital length of stay (23 versus 18 days, P < 0.05), higher complication rate (46% versus 33%, P = 0.09), and higher mortality (44% versus 11%, P < 0.01) when compared with patients with SCI without IAI. Intraabdominal injuries are common in blunt SCI. Liberal evaluation with computed tomography is necessary to identify injuries early.
Salim
Ali
A
Department of Surgery, Division of Trauma and Critical Care, University of Southern California Keck School of Medicine. asalim@surgery.usc.edu
Ottochian
Marcus
M
Gertz
Ryan J
RJ
Brown
Carlos
C
Inaba
Kenji
K
Teixeira
Pedro G R
PG
Rhee
Peter
P
Demetriades
Demetrios
D
D000007:Abdominal Injuries / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008159:Lumbar Vertebrae; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000453:epidemiology*; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000453:epidemiology*