Risk factors related to undetected injuries in laparotomized patients for abdominal trauma

Abstract

Objective: To determine risk factors related to undetected injuries in laparotomized patients for abdominal trauma in the General Surgery of the Hospital Manuel Núñez Tovar at Maturín, Estado Monagas, in the period between January and September 2008. Patients and method: It is a prospective, transversal, descriptive and observational study to identify the incidence of missed injuries in moderated and severe trauma patients submitted to exploratory laparotomy during the lapse recorded. It does evaluate age, gender, type of undetected injury, date of the incidence, Glasgow Coma Scale, hemodynamic stability, trauma indexes (ATI, RTI), and imagenologic studies. Results: There were 97 patients with 384 injuries, 42 of them undetected. The univariantic analysis related to missed lesions showed a RTI > 9 points (RR: 2,45 ), hemodynamic instability (RR: 2,18), Glasgow < 13 (RR: 18,5), ATI > 15 (RR: 1,71) and multiple trauma (RR: 1,62) Conclusions: There were identified several risk factors for missed injuries. We recommend insist in tertiary evaluation of all traumatized patients.