Title: Diagnosis and treatment of multiple severe injuries
Abstract: Objective To investigate the clinical features and surgical management of patients with blunt multiple severe injuries. Methods 165 patients whth the injury severity score (ISS) over 16 were reviewed between 1988 and 1998. Results 47 cases (28.5%) had 3 or more injury sites, and 63 cases had multiple intraabdominal organ trauma. Abdominal trauma was evaluated by abdominocentesis in 143 cases, by US in 65 and CT in 47. All had positive values over 90%. Missed diagnosis of intraabdominal injury occurred in 21 cases (12 7%). The total mortality rate was 17 6% (29 cases). The average ISS for the died was 41 6 and 24 8 for the survivors ( t =15 21, P 0 01). Conclusion In patients with multiple severe trauma, abdominocentesis is a helpful screening method, US and CT are also among the routine diagnostic measures for intraabdominal injuries. During laparotomy, concomitant organ injuries should be detected with proper care. In patients with multiple severe trauma, ISS over 40 indicates a poor prognosis.
Publication Year: 2001
Publication Date: 2001-01-01
Language: en
Type: article
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