title: Compartmental anatomical classification of traumatic abdominal injuries from the academic point of view and its potential clinical implication.
abstract: BACKGROUND
  The mechanism and outcome of traumatic abdominal injury (TAI) varies worldwide. Moreover, data comparing TAIs in each abdominal compartment are lacking. We aimed to assess from the academic point of view, TAI based on its anatomical compartments.
  
  
  METHODS
  We conducted a retrospective study for TAI patients between 2008 and 2011 in Qatar. Patients were categorized according to the involved anatomical compartment (C): intrathoracic (ITC), retroperitoneal (RPC), true abdomen (TAC), and pelvic abdomen (PAC) group. Chi Square test, One-Way ANOVA and multivariate regression analysis were appropriately performed.
  
  
  RESULTS
  Of 6,888 patients admitted to the trauma unit, 1,036 (15%) had TAI that were grouped as ITC (65%), RPC (15%), TAC (13%), and PAC (7%). The mean age was lowest in ITC (29 ± 13) and highest in TAC (34 ± 11) group, (P = 0.001). Motor vehicle crash was the main mechanism of injury in all groups except for PAC, in which fall dominated. Vast majority of expatriates had PAC and TAC injuries. The main abdominal injuries included liver (35%; ITC), spleen (32%; ITC) and kidneys (18%; RPC). Extra-abdominal injuries involved the head in RPC and ITC, lung in ITC and RPC and extremities in PAC. Mean ISS was higher in RPC and ITC. Abdominal AIS was higher in TAC injuries. Overall hospital mortality was 10%: RPC (15%), TAC (11%), ITC (9.4%) and PAC (1.5%). Concurrent traumatic brain injury (OR 5.3; P = 0.001) and need for blood transfusion (OR 3.03; P = 0.003) were the main independent predictors of mortality.
  
  
  CONCLUSIONS
  In addition to its academic value, the anatomical approach of TAI would be a complementary tool for better understanding and prediction of the pattern and outcome of TAI. This would be possible if further research find accurate, early diagnostic tool for this anatomical classification.
authors.affiliation: Clinical Research Unit, Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar ; Clinical Medicine, Weill Cornell Medical School, Doha, Qatar ; Internal Medicine, Ahmed Maher teaching Hospital, Cairo, Egypt.
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Menyar
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Husham
authors.initials: H
authors.lastname: Abdelrahman
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Hassan
authors.initials: H
authors.lastname: Al-Thani
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Zarour
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Ashok
authors.initials: A
authors.lastname: Parchani
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Ruben
authors.initials: R
authors.lastname: Peralta
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar ; Department of Surgery, University of Arizona, Tucson, AZ, USA.
authors.forename: Rifat
authors.initials: R
authors.lastname: Latifi
keywords: Abdominal injury; Anatomical compartment; Mortality; Trauma