Selective Management of Multiple Anterior Abdominal Stab Wounds: Is it Safe?
Abdominal Injuries
/ diagnosis
Adult
Female
Humans
Injury Severity Score
Intensive Care Units
/ statistics & numerical data
Israel
/ epidemiology
Laparoscopy
/ methods
Laparotomy
/ methods
Length of Stay
/ statistics & numerical data
Male
Mortality
Patient Care Management
/ methods
Peritoneal Lavage
/ methods
Retrospective Studies
Risk Assessment
/ methods
Risk Factors
Tomography, X-Ray Computed
/ methods
Wounds, Stab
/ diagnosis
Journal
The Israel Medical Association journal : IMAJ
ISSN: 1565-1088
Titre abrégé: Isr Med Assoc J
Pays: Israel
ID NLM: 100930740
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
entrez:
30
5
2019
pubmed:
30
5
2019
medline:
5
6
2019
Statut:
ppublish
Résumé
Selective management of stable patients with anterior abdomen stab wounds (AASWs) has become a gold standard management approach throughout the world. Evidenced-based options for supporting selective management include clinical follow-up, local wound exploration with or without diagnostic peritoneal lavage, diagnostic laparoscopy, and abdominal computerized tomography. The presence of multiple AASWs might signify a more aggressive attack and limit the safety of a selective management approach. To evaluate whether multiple AASWs are associated with an increased risk of intra-abdominal injury requiring emergency surgery. We retrospectively reviewed all AASW patients admitted to Assaf Harofeh Medical Center, Zerifin, Israel, and Hillel Yaffe Medical Center in Hadera, Israel, from 2007 to 2015. Patients were divided into two groups based on the number of stab wounds: single or multiple. Data were coded for demographics, severity of injury, presence of intra-abdominal injury, laparotomy rate, length of hospital stay (LOS), length of stay in the intensive care unit (LICU), and survival. The study included 169 patients. Of these, 143 patients had a single AASW and 26 had multiple AASWs. There were no differences between the groups regarding demographics, severity of injury, intra-abdominal penetration, specific organ injury, LOS, or LICU. There was no difference in the percentage of patients requiring laparotomy. The overall mortality was 2.36% (4/169). There was no significant difference in the mortality rate between the groups (P = 0.11). The presence of multiple AASWs is not a risk factor for increased frequency and severity of intra-abdominal injury.
Sections du résumé
BACKGROUND
BACKGROUND
Selective management of stable patients with anterior abdomen stab wounds (AASWs) has become a gold standard management approach throughout the world. Evidenced-based options for supporting selective management include clinical follow-up, local wound exploration with or without diagnostic peritoneal lavage, diagnostic laparoscopy, and abdominal computerized tomography. The presence of multiple AASWs might signify a more aggressive attack and limit the safety of a selective management approach.
OBJECTIVES
OBJECTIVE
To evaluate whether multiple AASWs are associated with an increased risk of intra-abdominal injury requiring emergency surgery.
METHODS
METHODS
We retrospectively reviewed all AASW patients admitted to Assaf Harofeh Medical Center, Zerifin, Israel, and Hillel Yaffe Medical Center in Hadera, Israel, from 2007 to 2015. Patients were divided into two groups based on the number of stab wounds: single or multiple. Data were coded for demographics, severity of injury, presence of intra-abdominal injury, laparotomy rate, length of hospital stay (LOS), length of stay in the intensive care unit (LICU), and survival.
RESULTS
RESULTS
The study included 169 patients. Of these, 143 patients had a single AASW and 26 had multiple AASWs. There were no differences between the groups regarding demographics, severity of injury, intra-abdominal penetration, specific organ injury, LOS, or LICU. There was no difference in the percentage of patients requiring laparotomy. The overall mortality was 2.36% (4/169). There was no significant difference in the mortality rate between the groups (P = 0.11).
CONCLUSIONS
CONCLUSIONS
The presence of multiple AASWs is not a risk factor for increased frequency and severity of intra-abdominal injury.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM