title: Risk factors for mortality in blunt abdominal trauma with surgical approach.
abstract: OBJECTIVE
  identify risk factors for mortality in patients who underwent laparotomy after blunt abdominal trauma.
  
  
  METHODS
  retrospective study, case-control, which were reviewed medical records of blunt trauma victims patients undergoing laparotomy, from March 2013 to January 2015, and compared the result of the deaths group with the group healed.
  
  
  RESULTS
  of 86 patients, 63% were healed, 36% died, and one patient was excluded from the study. Both groups had similar epidemiology and trauma mechanism, predominantly young adults males, automobilistic accident. Most cases that evolved to death had hemodynamic instability as laparotomy indication - 61% against 38% in the other group (p=0.02). The presence of solid organ injury was larger in the group of deaths - 80% versus 48% (p=0.001) and 61% of them had other associated abdominal injury compared to 25% in the other group (p=0.01). Of the patients who died 96% had other serious injuries associated (p=0.0003). Patients requiring damage control surgery had a higher mortality rate (p=0.0099). Only one of 18 patients with isolated hollow organ lesion evolved to death (p=0.0001). The mean injury score of TRISS of cured (91.70%) was significantly higher than that of deaths (46.3%) (p=0.002).
  
  
  CONCLUSIONS
  the risk factors for mortality were hemodynamic instability as an indication for laparotomy, presence of solid organ injury, multiple intra-abdominal injuries, need for damage control surgery, serious injury association and low index of trauma score.
authors.affiliation: Departamento de Cirurgia, Universidade Federal do Paraná, PR, Brazil.
authors.forename: Silvania Klug
authors.initials: SK
authors.lastname: Pimentel
authors.affiliation: Serviço de Cirurgia Geral, Hospital do Trabalhador, Universidade Federal do Paraná, PR, Brazil.
authors.forename: Guilherme Vinicius
authors.initials: GV
authors.lastname: Sawczyn
authors.affiliation: Faculdade de Medicina, Universidade Federal do Paraná, PR, Brazil.
authors.forename: Melissa Mello
authors.initials: MM
authors.lastname: Mazepa
authors.affiliation: Faculdade de Medicina, Universidade Federal do Paraná, PR, Brazil.
authors.forename: Felipe Guilherme Gonçalves
authors.initials: FG
authors.lastname: da Rosa
authors.affiliation: Departamento de Cirurgia, Universidade Federal do Paraná, PR, Brazil.
authors.forename: Adonis
authors.initials: A
authors.lastname: Nars
authors.affiliation: Serviço de Cirurgia Geral, Hospital do Trabalhador, Universidade Federal do Paraná, PR, Brazil.
authors.forename: Iwan Augusto
authors.initials: IA
authors.lastname: Collaço
mesh_terms: D000007:Abdominal Injuries / Q000401:mortality* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014949:Wounds, Nonpenetrating / Q000401:mortality* / Q000601:surgery*; D055815:Young Adult