Determinants of Successful Non-Operative Management of Intra-Peritoneal Bleeding Following Blunt Abdominal Trauma
Objectives: To identify the predictive factors of successful non-operative management of patients with intraperitoneal bleeding following blunt abdominal trauma.Methods: This was cross-sectional study being performed in our Level I trauma center in southern Iran between 2010 and 2011. We included ad...
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| Format: | Article |
| Language: | English |
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Shiraz University of Medical Sciences
2014-07-01
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| Series: | Bulletin of Emergency and Trauma |
| Subjects: | |
| Online Access: | http://beat.sums.ac.ir/article_44264_b2e30005ec4d048f028b718021c75647.pdf |
| _version_ | 1811236483146711040 |
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| author | Ammar Heidar Parsa Ravanfar Golnaz Namazi Taha Nikseresht Hadi Niakan |
| author_facet | Ammar Heidar Parsa Ravanfar Golnaz Namazi Taha Nikseresht Hadi Niakan |
| author_sort | Ammar Heidar |
| collection | DOAJ |
| description | Objectives: To identify the predictive factors of successful non-operative management of patients with intraperitoneal bleeding following blunt abdominal trauma.Methods: This was cross-sectional study being performed in our Level I trauma center in southern Iran between 2010 and 2011. We included adult (>14 years) patients with blunt abdominal trauma and intraperitoneal hemorrhage detected by CT-Scan who were hemodynamically stable and did not require any surgical intervention. Patients were managed conservatively in ICU. Those who required laparotomy during the study period were named as non-operative management failure (NOM-F) while the other were nonoperative management success (NOM-S). The baseline, clinical and laboratory characteristics were compared between two study groups in order to detect the predictors of successful NOM of intra-peritoneal bleeding.Results: Overall we included 80 eligible patients among whom there were 55 (68.7%) men and 25 (31.3%) women with mean age of 30.63.6± years. Finally, 43 (53.8%) were successfully managed conservatively (NOM-S) while 37 (46.2%) required laparotomy (NOM-F). We found that those who underwent emergency laparotomy had significantly higher ĘHb (p=0.016) and lower base deficit (p=0.005) when compared to those who were successfully managed conservatively. Those who required surgical intervention had significantly lower baseline systolic blood pressure (p<0.001) and higher shock index (p=0.002). The other parameters such as pulse rate and respiratory rate were comparable between two study groups.Conclusion: In patients with intra-peritoneal bleeding following blunt abdominal trauma, the most reliable predictive clinical and para-clinical factor of successful non-operative management are shock index and systolic blood pressure on arrival, base deficit and hemoglobin drop within first 12 hours of admission. |
| first_indexed | 2024-04-12T12:10:36Z |
| format | Article |
| id | doaj.art-c065e69e7d8b4fdd8bddff551123a42c |
| institution | Directory Open Access Journal |
| issn | 2322-2522 2322-3960 |
| language | English |
| last_indexed | 2024-04-12T12:10:36Z |
| publishDate | 2014-07-01 |
| publisher | Shiraz University of Medical Sciences |
| record_format | Article |
| series | Bulletin of Emergency and Trauma |
| spelling | doaj.art-c065e69e7d8b4fdd8bddff551123a42c2022-12-22T03:33:36ZengShiraz University of Medical SciencesBulletin of Emergency and Trauma2322-25222322-39602014-07-012Issue 312512944264Determinants of Successful Non-Operative Management of Intra-Peritoneal Bleeding Following Blunt Abdominal TraumaAmmar Heidar0Parsa Ravanfar1Golnaz Namazi2Taha Nikseresht3Hadi Niakan4Trauma Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, IranTrauma Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, IranTrauma Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, IranTrauma Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, IranTrauma Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, IranObjectives: To identify the predictive factors of successful non-operative management of patients with intraperitoneal bleeding following blunt abdominal trauma.Methods: This was cross-sectional study being performed in our Level I trauma center in southern Iran between 2010 and 2011. We included adult (>14 years) patients with blunt abdominal trauma and intraperitoneal hemorrhage detected by CT-Scan who were hemodynamically stable and did not require any surgical intervention. Patients were managed conservatively in ICU. Those who required laparotomy during the study period were named as non-operative management failure (NOM-F) while the other were nonoperative management success (NOM-S). The baseline, clinical and laboratory characteristics were compared between two study groups in order to detect the predictors of successful NOM of intra-peritoneal bleeding.Results: Overall we included 80 eligible patients among whom there were 55 (68.7%) men and 25 (31.3%) women with mean age of 30.63.6± years. Finally, 43 (53.8%) were successfully managed conservatively (NOM-S) while 37 (46.2%) required laparotomy (NOM-F). We found that those who underwent emergency laparotomy had significantly higher ĘHb (p=0.016) and lower base deficit (p=0.005) when compared to those who were successfully managed conservatively. Those who required surgical intervention had significantly lower baseline systolic blood pressure (p<0.001) and higher shock index (p=0.002). The other parameters such as pulse rate and respiratory rate were comparable between two study groups.Conclusion: In patients with intra-peritoneal bleeding following blunt abdominal trauma, the most reliable predictive clinical and para-clinical factor of successful non-operative management are shock index and systolic blood pressure on arrival, base deficit and hemoglobin drop within first 12 hours of admission.http://beat.sums.ac.ir/article_44264_b2e30005ec4d048f028b718021c75647.pdfBlunt abdominal traumaIntra-peritoneal bleedingNon-operative managementConservative therapy |
| spellingShingle | Ammar Heidar Parsa Ravanfar Golnaz Namazi Taha Nikseresht Hadi Niakan Determinants of Successful Non-Operative Management of Intra-Peritoneal Bleeding Following Blunt Abdominal Trauma Bulletin of Emergency and Trauma Blunt abdominal trauma Intra-peritoneal bleeding Non-operative management Conservative therapy |
| title | Determinants of Successful Non-Operative Management of Intra-Peritoneal Bleeding Following Blunt Abdominal Trauma |
| title_full | Determinants of Successful Non-Operative Management of Intra-Peritoneal Bleeding Following Blunt Abdominal Trauma |
| title_fullStr | Determinants of Successful Non-Operative Management of Intra-Peritoneal Bleeding Following Blunt Abdominal Trauma |
| title_full_unstemmed | Determinants of Successful Non-Operative Management of Intra-Peritoneal Bleeding Following Blunt Abdominal Trauma |
| title_short | Determinants of Successful Non-Operative Management of Intra-Peritoneal Bleeding Following Blunt Abdominal Trauma |
| title_sort | determinants of successful non operative management of intra peritoneal bleeding following blunt abdominal trauma |
| topic | Blunt abdominal trauma Intra-peritoneal bleeding Non-operative management Conservative therapy |
| url | http://beat.sums.ac.ir/article_44264_b2e30005ec4d048f028b718021c75647.pdf |
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