title: Profile, outcome and predictors of mortality of abdomino-pelvic trauma patients in a tertiary intensive care unit in Saudi Arabia.
abstract: BACKGROUND
  The Kingdom of Saudi Arabia (KSA) is one of countries with the world's highest number of deaths per 100,000 populations from road traffic accidents (RTAs). Numerous trauma victims sustain abdomino-pelvic injuries, which are associated with considerable morbidity and mortality. The purpose of this study was to describe profile, outcomes and predictors of mortality of patients with abdomino-pelvic trauma admitted to the intensive care unit (ICU) in a tertiary care trauma centre in Riyadh, KSA.
  
  
  METHODS
  This was a retrospective analysis of prospectively collected ICU database. All consecutive patients older than 14 years with abdomino-pelvic trauma from March 1999 to June 2013 were included. The followings were extracted: demographics, injury severity, mechanism and type of injury, associated injuries, use of vasopressors and mechanical ventilation, and worst laboratory results in the first 24h. The primary outcome was hospital mortality. We compared profile and outcomes between survivors and non-survivors and reported predictors of mortality.
  
  
  RESULTS
  Of the 11,374 trauma patients who were admitted to the hospital during the study period, 2120 (18.6%) patients had abdomino-pelvic injuries, out of which 702 (33.1%) patients were admitted to the ICU. The mean age was 30.7 (SD 14.4) years and the majority was male (89.5%). RTA was the most common cause of abdomino-pelvic trauma (70.4%). Pelvis (46.2%), liver (25.8%), and spleen (23.1%) were the most frequently injured organs; and chest (55.6%), head (41.9%), and lower extremities (27.5%) were the most commonly associated injuries. Mechanical ventilation was required in 89.6% with a mean duration of 9.1 (SD 9.2) days and emergency surgery was performed in 45.0% of the patients with prolonged ICU and hospital length of stay (10.8 [SD 10.8], 56.9 [SD 96.7] days; respectively). Of the 702 patients with abdomino-pelvic trauma, 115 (16.4%) patients did not survive. Associated head trauma and retroperitoneal haematoma, higher level of lactic acid on admission and ISS, and advanced age were potential risk factors for hospital mortality.
  
  
  CONCLUSIONS
  Abdomino-pelvic injuries are common in trauma patients, affecting mainly young male victims, and are associated with significant morbidity and mortality, and resource utilisation.
authors.affiliation: Surgical Intensive Care Unit, Intensive Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: haddads55@yahoo.com.
authors.forename: Samir H
authors.initials: SH
authors.lastname: Haddad
authors.affiliation: Department of Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: yousefz@ngha.med.sa.
authors.forename: Zeyad M
authors.initials: ZM
authors.lastname: Yousef
authors.affiliation: Department of Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: azzams1@ngha.med.sa.
authors.forename: Saleh S
authors.initials: SS
authors.lastname: Al-Azzam
authors.affiliation: Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: aldawooda@hotmail.com.
authors.forename: Abdulaziz S
authors.initials: AS
authors.lastname: AlDawood
authors.affiliation: Department of Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: zahraniaa@ngha.med.sa.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Al-Zahrani
authors.affiliation: Department of Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: zamelh@ngha.med.sa.
authors.forename: Heythem A
authors.initials: HA
authors.lastname: AlZamel
authors.affiliation: King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, Riyadh, Saudi Arabia; Department of Internal Medicine, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: hani_t@hotmail.com.
authors.forename: Hani M
authors.initials: HM
authors.lastname: Tamim
authors.affiliation: King Abdullah International Medical Research Center (KAIMRC), King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: deebah@ngha.med.sa.
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: Deeb
authors.affiliation: Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences, Respiratory Services, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Electronic address: yaseenarabi@yahoo.com.
authors.forename: Yaseen M
authors.initials: YM
authors.lastname: Arabi
mesh_terms: D000007:Abdominal Injuries / Q000150:complications / Q000401:mortality* / Q000601:surgery; D000063:Accidents, Traffic / Q000401:mortality*; D000328:Adult; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009104:Multiple Trauma / Q000150:complications / Q000401:mortality* / Q000601:surgery; D017063:Outcome Assessment, Health Care; D010388:Pelvis / Q000293:injuries*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D015996:Survival Rate; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000401:mortality* / Q000601:surgery
keywords: Abdominal trauma; Abdomino-pelvic injury; Abdomino-pelvic trauma; Mortality; Multiple trauma; Outcome; Pelvic trauma; Profile