Factors influencing mortality in patients with abdominal trauma undergoing damage control therapy

Damage control surgery aims to reduce mortality in patients with severe abdominal trauma by limiting prolonged interventions under unfavorable physiological conditions. This study aimed to identify factors associated with mortality in these patients, including sex, age, cause and mechanism of injury, trauma severity index, hypothermia, metabolic acidosis, and variables related to intensive care, anesthesia, surgical management, and laboratory findings at admission to the intensive care unit (ICU).

This retrospective observational cohort study analyzed 136 medical records of patients with abdominal trauma who underwent damage control surgery at a tertiary trauma hospital in Curitiba, Paraná, Brazil. Clinical, surgical, and laboratory variables were evaluated. Survivors and non-survivors were compared using univariate and multivariate statistical analyses to determine the significance of the findings.

Relevant findings included higher trauma severity scores among patients who died (mean Injury Severity Score [ISS] of 34 in non-survivors vs 29 in survivors; p=0.017). Hypothermia at admission was significantly associated with mortality. Metabolic acidosis at ICU admission was also associated with unfavorable outcomes, represented by a low bicarbonato value as well as a low base excess (BE) value of -12 compared with -8.6 (p<0.001).

Higher ISS values, more negative BE, and hypothermia were independent predictors of mortality in patients undergoing damage control therapy for abdominal trauma.