Intra-Abdominal Sepsis Complicating Abdominal Trauma
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- Category: Vol. 77, June 2009
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Intra-Abdominal Sepsis Complicating Abdominal Trauma,AHMAD AL-SHANDAWILLY, SAMIR ABD AL-SALAM, SAMEH GABR, MANSOUR ABD AL-KHALEK, AMER YEHIA, AHMAD ABD ALFATAH and NASR AL-GALLALY
Abstract
Hypothesis: Identifying patients with risk factors associ-ated with the development of intra-abdominal infections makes possible early interventions to minimize morbidity and mor-tality. We sought to determine the incidence of intra-abdominal infection (organ/space surgical site infection) in patients undergoing operation because of abdominal trauma, to identify the risk factors associated with the development of this complication and to estimate the respective magnitudes of the risk factors.
Design: We performed a prospective cohort study in patients older than 16 years who were treated surgically for penetrating or blunt abdominal trauma, with or without other associated lesions.
Patients: 116 patients with abdominal trauma were ad-mitted to the department of surgery. Of these, we excluded 2 (1.7%) who underwent operation at different institutions; 9 (7.8%) who died within 48 hours after admission and 5 (4.3%) in whom complete follow-up (until the 30th postoperative day) was not feasible. The final study sample consisted of 100 patients.
Main Outcome Measure: We performed univariate analysis to explore in an isolated way the behavior of the dependent and independent variables. Bivariate analysis was carried out with each of the independent variables and the main outcome to establish the association between individual risk factors and intra-abdominal infection. Finally, a logistic regression model was developed using the SPSS 10.0 program and the forward method.
Results: Intra-abdominal infection developed in 10 patients (10%). Variables independently associated with this compli-cation were an Abdominal Trauma Index greater than 24, abdominal contamination and admission to the intensive care unit.
Conclusions: The development of intra-abdominal infec-tion in patients undergoing operation because of abdominal trauma is a complex phenomenon resulting from the multiple risk factors during the preoperative, intraoperative and post-operative periods. Multivariate logistic regression analysis allowed us to identify an Abdominal Trauma Index greater than 24, contamination of the abdominal cavity, and admission to the intensive care unit as independent risk factors for the development of organ/space surgical site infection.