Traumatismo abdominal en un hospital de tercer nivel. Análisis de resultados, consideraciones terapéuticas y evaluación con índices pronóstico

Objectives. To describe the abdominal injuries treated in our hospital. We assessed the behavior and reliability of prognostic scales, analyzing the correlations between them and therapeutic decisions and outcomes. Methods. Retrospective study including all patients with major abdominal injuries admitted to our hospital between 2009 and 2015. We gathered epidemiologic and clinical data, outcomes, and scores on several prognostic scales. Results. The median age of the 153 patients we identified from case records was 38 years; 73.9% were males. Most cases involved blunt trauma (94.1%) sustained in traffic accidents (60.1%). The spleen and the liver were the organs most often affected (in 44.4% and 36.6%, respectively). The median length of stay in the hospital was 11 days, and overall mortality was 13%. Although conservative management was successful in 62.7% of the cases, we found that patients who had a higher ISS (Injury Severity Score) or TRISS (Trauma and Injury Severity Score) assessments more often required surgery or died (P=.0001, both comparisons). Those who had longer hospital stays had a higher Revised Trauma Score or TRISS (P=.001 and P=.016, respectively). Conclusions. The causes of abdominal injuries and the types treated in our hospital were similar to those described for the rest of Spain. Punctuation on prognostic severity scales correlated directly with the need for surgery, length of hospital stay, complications, and mortality.