Non-operative management of blunt abdominal trauma. Is it safe and feasible in a district general hospital?
<p>Abstract</p> <p>Background</p> <p>To evaluate the feasibility and safety of non-operative management (NOM) of blunt abdominal trauma in a district general hospital with middle volume trauma case load.</p> <p>Methods</p> <p>Prospective protocol...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2009-05-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Online Access: | http://www.sjtrem.com/content/17/1/22 |
| _version_ | 1818064113866113024 |
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| author | Giannopoulos George A Katsoulis Iraklis E Tzanakis Nikolaos E Patsaouras Panayotis A Digalakis Michalis K |
| author_facet | Giannopoulos George A Katsoulis Iraklis E Tzanakis Nikolaos E Patsaouras Panayotis A Digalakis Michalis K |
| author_sort | Giannopoulos George A |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>To evaluate the feasibility and safety of non-operative management (NOM) of blunt abdominal trauma in a district general hospital with middle volume trauma case load.</p> <p>Methods</p> <p>Prospective protocol-driven study including 30 consecutive patients who have been treated in our Department during a 30-month-period. Demographic, medical and trauma characteristics, type of treatment and outcome were examined. Patients were divided in 3 groups: those who underwent immediate laparotomy (OP group), those who had a successful NOM (NOM-S group) and those with a NOM failure (NOM-F group).</p> <p>Results</p> <p>NOM was applied in 73.3% (22 patients) of all blunt abdominal injuries with a failure rate of 13.6% (3 patients). Injury severity score (ISS), admission hematocrit, hemodynamic status and need for transfusion were significantly different between NOM and OP group. NOM failure occurred mainly in patients with splenic trauma.</p> <p>Conclusion</p> <p>According to our experience, the hemodynamically stable or easily stabilized trauma patient can be admitted in a non-ICU ward with the provision of close monitoring. Splenic injury, especially with multiple-site free intra-abdominal fluid in abdominal computed tomography, carries a high risk for NOM failure. In this series, the main criterion for a laparotomy in a NOM patient was hemodynamic deterioration after a second rapid fluid load.</p> |
| first_indexed | 2024-12-10T14:30:50Z |
| format | Article |
| id | doaj.art-dee929bc5faf4b34abb5aec0fe114c87 |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-12-10T14:30:50Z |
| publishDate | 2009-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-dee929bc5faf4b34abb5aec0fe114c872022-12-22T01:44:56ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412009-05-011712210.1186/1757-7241-17-22Non-operative management of blunt abdominal trauma. Is it safe and feasible in a district general hospital?Giannopoulos George AKatsoulis Iraklis ETzanakis Nikolaos EPatsaouras Panayotis ADigalakis Michalis K<p>Abstract</p> <p>Background</p> <p>To evaluate the feasibility and safety of non-operative management (NOM) of blunt abdominal trauma in a district general hospital with middle volume trauma case load.</p> <p>Methods</p> <p>Prospective protocol-driven study including 30 consecutive patients who have been treated in our Department during a 30-month-period. Demographic, medical and trauma characteristics, type of treatment and outcome were examined. Patients were divided in 3 groups: those who underwent immediate laparotomy (OP group), those who had a successful NOM (NOM-S group) and those with a NOM failure (NOM-F group).</p> <p>Results</p> <p>NOM was applied in 73.3% (22 patients) of all blunt abdominal injuries with a failure rate of 13.6% (3 patients). Injury severity score (ISS), admission hematocrit, hemodynamic status and need for transfusion were significantly different between NOM and OP group. NOM failure occurred mainly in patients with splenic trauma.</p> <p>Conclusion</p> <p>According to our experience, the hemodynamically stable or easily stabilized trauma patient can be admitted in a non-ICU ward with the provision of close monitoring. Splenic injury, especially with multiple-site free intra-abdominal fluid in abdominal computed tomography, carries a high risk for NOM failure. In this series, the main criterion for a laparotomy in a NOM patient was hemodynamic deterioration after a second rapid fluid load.</p>http://www.sjtrem.com/content/17/1/22 |
| spellingShingle | Giannopoulos George A Katsoulis Iraklis E Tzanakis Nikolaos E Patsaouras Panayotis A Digalakis Michalis K Non-operative management of blunt abdominal trauma. Is it safe and feasible in a district general hospital? Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| title | Non-operative management of blunt abdominal trauma. Is it safe and feasible in a district general hospital? |
| title_full | Non-operative management of blunt abdominal trauma. Is it safe and feasible in a district general hospital? |
| title_fullStr | Non-operative management of blunt abdominal trauma. Is it safe and feasible in a district general hospital? |
| title_full_unstemmed | Non-operative management of blunt abdominal trauma. Is it safe and feasible in a district general hospital? |
| title_short | Non-operative management of blunt abdominal trauma. Is it safe and feasible in a district general hospital? |
| title_sort | non operative management of blunt abdominal trauma is it safe and feasible in a district general hospital |
| url | http://www.sjtrem.com/content/17/1/22 |
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