Correlation between grades of injury, quantitative dysfunction and impact on functional outcomes and quality of life in blunt injury abdomen : A prospective study

Anupam Shukla; Dheeraj Raj; Nitin Kumar; Yogita Singh

Volume : VII, Issue : XI, November - 2018

Correlation between grades of injury, quantitative dysfunction and impact on functional outcomes and quality of life in blunt injury abdomen : A prospective study

Anupam Shukla, Dheeraj Raj, Nitin Kumar, Yogita Singh

Abstract :

Introduction . Injury has been man’s constant companion since earliest times. Blunt Abdominal trauma is one of the common associated injuries caused mainly due to road traffic accidents^1,2. The rapid increase in number of motor vehicles and its aftermath has caused rapid increase in number of victims to blunt abdominal trauma. Motor vehicle accidents account for 75 to 80 % of blunt abdominal trauma³. Blunt injury of abdomen is also a result of fall from height, assault with blunt objects, industrial mishaps, sport injuries, bomb blast and fall from riding bicycle. Modern trauma care has been increasing in sophistication all the time. However despite its huge importance blunt trauma has been called the neglected disease of modern society.Rapid resuscitation is necessary to save the unstable but salvageable patient with abdominal trauma.When the diagnosis is in doubt and clinical judgment suggests surgery, exploration provides definitive treatment as well as diagnosis; moreover, the risks of negative exploration have become acceptable⁴.

Aims = The objectives of the study are to evaluate correlation between grades of injury and quantitative dysfunction and impact on functional outcomes and quality of life in Blunt trauma abdomen and to evaluate pattern of abdominal organ involvement in blunt trauma abdomen patients presented in SVBP hospital.

Methods = the study was conducted in SVBP hospital meerut between june 2016 to October 2017. Total of 120 patients with history of blunt trauma abdomen were admitted in department of surgery during this period and were analysed prospectively. The data was analysed by SPSS 21.0 version.

Results = Abdominal trauma patients constituted 7.2% of the total trauma patients being the third most common cause of trauma after head trauma (51.2%) and extremity trauma (36.1%). In 71 cases of abdominal truma patients 45(63.3%) cases were of blunt trauma abdomen and 26(36.7%) cases were of penetrating trauma abdomen. Most common mode of injury was found to be road traffic accident in the adult age group (15–40 yrs).Most common mode of injury in blunt injury abdomen was found to be road traffic accident (69%).Most common mode of injury in penetrating trauma abdomen was found to be firearm injury (73.9%).Overall most common mode of injury was road traffic accident followed by fall from height followed by firearm injury.96% of our patients presented with abdominal pain followed by abdominal distension in 54.8%. Least patients presented with hematuria accounting for 12.5% patients. In our study, ultra sound abdomen was done is 99 cases. X–ray erect abdomen was done in 98 cases. Four quadrant aspiration was done in 90 cases. CECT was performed in 43 cases. Those patients who did not underwent CECT either they were taken for laparotomy or hemodyanamically unstable. In the present study, 67 (64.4%) out of 104 cases were managed surgically. The time interval between admission and surgery varied from 1–96 hours. 15 cases (22.4%) were operated within 3 hours of admission. 22 cases (32.8%) were operated 4–6 hours after admission. 12 cases (17.9%) were operated 13–24 hour after admission, 2 case (3.0%) were operated more than 24 hours after admission.