title: Contemporary characteristics of blunt abdominal trauma in a regional series from the UK.
abstract: INTRODUCTION Blunt abdominal trauma (BAT) is a common injury in recent trauma series. The characteristics of patients with BAT have changed following the reconfiguration of UK trauma services. The aim of this study was to build a new profile for BAT patients undergoing immediate or delayed laparotomy. METHODS All 5,401 consecutive adults presenting with major trauma between April 2012 and April 2014 in the 3 major trauma centres in the West Midlands were analysed to identify all patients with BAT. A total of 2,793 patients with a mechanism of injury or symptomatology consistent with BAT were identified (52%). Outcomes were analysed using local electronic clinical results systems and notes. RESULTS Of the 2,793 patients, 179 (6.4%) had a mesenteric or hollow viscus injury, 168 (6.0%) had a hepatobiliary injury, 149 (5.4%) had a splenic injury and 46 (1.6%) had a vascular injury. Overall, 103 patients (3.7%) underwent an early (<12 hours) laparotomy while 30 (1.1%) underwent a delayed (>12 hours) laparotomy. Twenty (66.7%) of those undergoing a delayed laparotomy had a hollow viscus injury. In total, 170 deaths occurred among the BAT patients (6.1%). In the early laparotomy group, 53 patients died (51.5%) whereas in the delayed laparotomy group, 6 patients died (20.0%). CONCLUSIONS This series has attempted to provide the characteristics of patients with BAT in a large contemporary UK cohort. BAT was found to be a common type of injury. Early and delayed laparotomy occurred in 3.7% and 1.1% of these patients respectively, mostly because of hollow viscus injury in both cases. Outcomes were comparable with those in the international literature from regions with mature trauma services.
authors.affiliation: University Hospitals Coventry and Warwickshire NHS Trust , UK.|Contributed equally.
authors.forename: R
authors.initials: R
authors.lastname: Pande
authors.affiliation: University of Leicester , UK.|Contributed equally.
authors.forename: A
authors.initials: A
authors.lastname: Saratzis
authors.affiliation: University Hospitals Coventry and Warwickshire NHS Trust , UK.
authors.forename: J
authors.initials: J
authors.lastname: Winter Beatty
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust , UK.
authors.forename: C
authors.initials: C
authors.lastname: Doran
authors.affiliation: University Hospitals of North Midlands NHS Trust , UK.
authors.forename: R
authors.initials: R
authors.lastname: Kirby
authors.affiliation: University Hospitals Coventry and Warwickshire NHS Trust , UK.
authors.forename: C
authors.initials: C
authors.lastname: Harmston
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology / Q000601:surgery*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers / Q000706:statistics & numerical data; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000601:surgery*
keywords: Laparotomy; Major trauma centre; Outcomes; Trauma