Independent predictors of morbidity and mortality in blunt colon trauma
Department of Cell Biology; Information Services, Academic Computing Services; Department of Surgery
Adolescent; Adult; Cerebral Hemorrhage; Cohort Studies; Colon; Digestive System Surgical Procedures; Female; Heart Injuries; Humans; Liver; Lung; Male; Middle Aged; Multiple Trauma; Predictive Value of Tests; Rectum; Sex Factors; Wounds, Nonpenetrating
Gastroenterology | Surgery
We sought to determine the impact of (1) grade of the colon injury, (2) the formation of an ostomy, and (3) associated injuries on outcomes such as morbidity and mortality after blunt colon injuries. We retrospectively reviewed 16,814 cases of blunt abdominal trauma. Patients with colonic injuries were selected and charts reviewed for demographic, clinical, and outcomes data. Injuries were grouped by the Colon Injury Scale (grades I-V). Independent risk factors of morbidity included spine and lung injuries, as well as increased age. A higher grade of colon injury trended toward a significant association with intra-abdominal complications. Independent risk factors of mortality included liver, heart, and lung injuries, as well as intracerebral blood and female gender. The grade of colon injury, the formation of an ostomy, and management of the colon trauma did not independently predict increased intra-abdominal complications, morbidity, or mortality. These results indicate that patients afflicted with blunt colon trauma experience a high rate of morbidity and mortality from associated injuries and or increased age. Treatment regimens directed at these factors will be most helpful in reducing the high morbidity and mortality after blunt colon trauma. Factors such as ostomy formation and management strategy are not associated with increased morbidity or mortality after blunt colon trauma.
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Citation: Am Surg. 2004 Jan;70(1):75-9.