War abdominal trauma: Usefulness of penetrating abdominal trauma index, injury severity score, and number of injured abdominal organs as predictive factors

Abstract

Objective: To analyze predictive factors for developing complications or lethal outcome in war abdominal trauma. Design: Retrospective study. Methods: We analyzed 93 cases of war penetrating abdominal trauma treated at the General Hospital Karlovac, Croatia. The following potential predictor variables were analyzed: age, sex, type of wound, Penetrating Abdominal Trauma Index (PATI), Injury Severity Score (ISS), and number of injured abdominal organs (NIAO). Results: A total of 10.8% of wounded patients died and 25.8% developed complications. The overall average number of injured intra-abdominal organs was 2.0; in the group of patients with complications, the average was 3.0, and in the group of deceased patients, the average was 3.5. The most frequently injured organs were the small and large bowels. The significant predictors of developing complications as well as death outcome were the PATI, the ISS, and the NIAO. The best diagnostic efficiency (79.57%) for predicting complications was with the NIAO, whereas the best model for the prediction of death outcome combined all three variables (Z = -13.0776 + 0.1561 × PATI + 0.281 × ISS - 0.5234 × NIAO), with diagnostic efficiency of 92.47%. Conclusion: These models may be used as important prognostic factors in war abdominal injuries.