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Correlation of trauma scoring systems with abdominal septic complications in abdominal trauma
Vikesh Agrawal1, Dhananjaya Sharma, V K Raina
1Department of Surgery, Netaji Subhash Chandra Bose Government Medical College and Allied Hospitals, Jabalpur, MP.
Introduction:
Anatomical trauma scoring systems can predict the occurrence of postoperative abdominal septic complications (ASC) after major abdominal trauma; however, this has not been validated in any Indian study. We attempted such an evaluation in patients attending a teaching hospital in central India.
Method:
A retrospective analysis of data from 169 patients who had undergone emergency laparotomy for penetrating or blunt abdominal injury between August 1996 and July 2001 was done. Every patient was scored using three trauma severity indices and the occurrence of ASC was identified.
Results:
Patients who developed ASC had higher trauma severity scores than those who did not. Thirty-eight patients had isolated small bowel injury; trauma scores underestimated the occurrence of ASC in these patients.
Conclusions:
Trauma severity indices may serve as useful tools to predict the occurrence of postoperative ASC in patients with abdominal trauma, except in those with isolated small bowel injury. There is thus a need to modify the weight of small bowel injury in these scoring systems.