Show simple item record

dc.contributor.authorIbrahim, W.
dc.contributor.authorHirshon, J.M.
dc.contributor.authorEl-Shinawi, M.
dc.date.accessioned2020-05-18T19:43:56Z
dc.date.available2020-05-18T19:43:56Z
dc.date.issued2020
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85084210050&doi=10.1016%2fj.afjem.2020.02.002&partnerID=40&md5=4118909e80701a71cf17752f00620494
dc.identifier.urihttp://hdl.handle.net/10713/12774
dc.description.abstractIntroduction Despite agreement in the literature that “stable” blunt trauma patients may be managed conservatively, in Egypt many such patients receive operative management. This paper presents the results of a pragmatic, prospective, observational study to evaluate outcomes of non-operative (NOP) versus operative (OP) management of blunt abdominal solid organ trauma in hemodynamically stable adults admitted to Tanta University Emergency Hospital (TUH) in Egypt. Methods A prospective observational study enrolled adult blunt abdominal trauma patients with solid organ injury at TUH over a 3-year period (June 2014–June 2017). Inclusion criteria were age ≥18 yr, mean arterial pressure >65 mm Hg, heart rate <110 bpm, hematocrit ≥7 mg/dl, and abdominal organ injury diagnosed by ultrasound or computed tomography (CT). Excluded patients were those with pelvis and femur fractures; patients with penetrating abdominal trauma; predominate burn injuries, children and pregnant women. All patients were assigned to non-operative or operative management based on clinician preference. Outcomes of interest were 30-day mortality, blood transfusion volume, and length of stay. Descriptive statistics and χ2 were used to compare outcomes. Results During the study period, 4254 trauma patients presented to TUH. Of these, 790 had blunt abdominal trauma and 111 (14.1%) met inclusion criteria. Injury severity scores for each group were comparable (24 ± 10 – NOP vs. 28 ± 11 – OP, p = 0.126). NOP received less transfused blood (213.41 ± 360.3 ml [NOP] vs.1155.17 ± 380.4 ml [OP] (p < 0.0001)) but had a longer length of stay (8.29 ± 2.8 [NOP] vs. 6.45 ± 1.97 days [OP] (p = 0.012)). There was no difference in mortality between groups (p = 0.091). Conclusion Our study demonstrated that non-operative management in Egypt of blunt abdominal trauma was safe and resulted in fewer procedures, fewer units of blood transfused, and no increase in mortality. Longer length of stay for non-operative patients might reflect treating physician caution in their management.en_US
dc.description.sponsorshipFunding support from Health Fogarty International Center grant 5D43TW007296 from the National Institutes of Health .en_US
dc.description.urihttps://doi.org/10.1016/j.afjem.2020.02.002en_US
dc.language.isoen_USen_US
dc.publisherAfrican Federation for Emergency Medicineen_US
dc.relation.ispartofAfrican Journal of Emergency Medicine
dc.subjectBlunt abdominal traumaen_US
dc.subjectNon-operative managementen_US
dc.subjectOperativeen_US
dc.subjectSolid organsen_US
dc.titleNon-operative management of blunt abdominal solid organ trauma in adult patientsen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.afjem.2020.02.002


Files in this item

Thumbnail
Name:
Publisher version

This item appears in the following Collection(s)

Show simple item record