title: The influence of the risk factor on the abdominal complications in colon injury management.
abstract: BACKGROUND
  The management of colon injuries has distinctly evolved over the last three decades. However, trauma surgeons often find themselves in a dilemma, whether to perform a diversion or to perform a primary repair. The purpose of this study is to evaluate risk factors in colon injury management and their influence on abdominal complications.
  
  
  METHODS
  This is a prospective study conducted at a national level I trauma center in Tirana, Albania from January 2009 to December 2012. The data with respect to demographics, physiological risk factors, intraoperative findings, and surgical procedures were collected. Colonic injury-related morbidity and mortality were analyzed. Multivariate logistic regression analysis was performed by assessing the influence of risk factors on abdominal complications.
  
  
  RESULTS
  Of the 157 patients treated with colon injury, was performed a primary repair in 107 (68.15%) of the patients and a diversion in the remaining 50 (31.85%). The mean PATI was 18.6, while 37 (23.6%) of patients had PATI greater than 25. The complications and their frequencies according to the surgical technique used (primay repair vs diversion respectively) includes: wound infections (9.3% vs 50%), anastomotic leak (1.8% vs 8.7%), and intra-abdominal abscess (1.8% vs 6.5%). The multivariate analysis identified two independent risk factors for abdominal complications: transfusions of 4 units of blood within the first 24 hours (OR = 1.2 95% CI (1.03 - 1.57) p =0.02), and diversion (OR = 9.6, 95% CI 4.4 - 21.3, p<0.001).
  
  
  CONCLUSIONS
  Blood transfusions of more than 4 units within the first 24 hours and diversion during the management of destructive colon injuries are both independent risk factors for abdominal complications. The socioeconomic impact and the need for a subsequent operation in colostomy patients are strong reasons to consider primary repair in the management of colon injuries.
authors.forename: M
authors.initials: M
authors.lastname: Torba
authors.forename: A
authors.initials: A
authors.lastname: Gjata
authors.forename: S
authors.initials: S
authors.lastname: Buci
authors.forename: G
authors.initials: G
authors.lastname: Bushi
authors.forename: A
authors.initials: A
authors.lastname: Zenelaj
authors.forename: I
authors.initials: I
authors.lastname: Kajo
authors.forename: S
authors.initials: S
authors.lastname: Koceku
authors.forename: K
authors.initials: K
authors.lastname: Kagjini
authors.forename: K
authors.initials: K
authors.lastname: Subashi
mesh_terms: D018784:Abdominal Abscess / Q000453:epidemiology; D000007:Abdominal Injuries / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000415:Albania / Q000453:epidemiology; D057868:Anastomotic Leak / Q000453:epidemiology; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002648:Child; D003082:Colectomy; D003106:Colon / Q000293:injuries* / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D006801:Humans; D007081:Ileostomy; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014193:Trauma Centers; D016896:Treatment Outcome; D014946:Wound Infection / Q000453:epidemiology; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000601:surgery*