Cargando…
Association between intra-abdominal injured organs and abdominal compartment syndrome in patients with severe blunt trauma: A propensity score matched study using nationwide trauma registry in Japan
INTRODUCTION: Abdominal compartment syndrome (ACS) after blunt abdominal trauma is a rare complication that requires early recognition and subsequent surgical intervention for optimal outcome. We aimed to investigate how differences in injured abdominal organs affect ACS development in patients with...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204983/ https://www.ncbi.nlm.nih.gov/pubmed/37220117 http://dx.doi.org/10.1371/journal.pone.0286124 |
_version_ | 1785045944582012928 |
---|---|
author | Komori, Akira Iriyama, Hiroki Kainoh, Takako Aoki, Makoto Abe, Toshikazu |
author_facet | Komori, Akira Iriyama, Hiroki Kainoh, Takako Aoki, Makoto Abe, Toshikazu |
author_sort | Komori, Akira |
collection | PubMed |
description | INTRODUCTION: Abdominal compartment syndrome (ACS) after blunt abdominal trauma is a rare complication that requires early recognition and subsequent surgical intervention for optimal outcome. We aimed to investigate how differences in injured abdominal organs affect ACS development in patients with severe blunt abdominal trauma. METHODS: This nested case-control study used a nationwide registry of trauma patients, namely, the Japan Trauma Data Bank (JTDB), and only included patients aged ≥ 18 years with blunt severe abdominal trauma, defined as an AIS score of abdomen ≥ 3, sustained between 2004 and 2017. Patients without ACS were used as control subjects and identified using propensity score (PS) matching. Characteristics and outcomes between patients with and without ACS were compared and logistic regression was used to identify specific risk factors for ACS. RESULTS: Among 294,274 patients in the JTDB, 11,220 were eligible for inclusion before PS matching, and 150 (1.3%) developed ACS after trauma. PS matching led to the inclusion of 131 and 655 patients with and without ACS, respectively. Compared to controls, patients with ACS had higher number of injured organs in the abdomen and displayed a greater frequency of vascular and pancreatic injuries, need for blood transfusion, and disseminated intravascular coagulopathy, a complication of ACS. In-hospital mortality was higher in patients with ACS than those without ACS (51.1% vs. 26.0%, p < 0.01). Logistic regression analysis revealed that a higher number of injured organs in the abdomen [odds ratio (OR) (95% confidence interval [CI]): 1.76 (1.23–2.53)] and pancreatic injury [OR (95% CI): 1.53 (1.03–2.27)] were independently associated with ACS. CONCLUSIONS: Greater number of injured organs in abdomen and pancreatic injury are independent risk factors for the development of ACS. |
format | Online Article Text |
id | pubmed-10204983 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-102049832023-05-24 Association between intra-abdominal injured organs and abdominal compartment syndrome in patients with severe blunt trauma: A propensity score matched study using nationwide trauma registry in Japan Komori, Akira Iriyama, Hiroki Kainoh, Takako Aoki, Makoto Abe, Toshikazu PLoS One Research Article INTRODUCTION: Abdominal compartment syndrome (ACS) after blunt abdominal trauma is a rare complication that requires early recognition and subsequent surgical intervention for optimal outcome. We aimed to investigate how differences in injured abdominal organs affect ACS development in patients with severe blunt abdominal trauma. METHODS: This nested case-control study used a nationwide registry of trauma patients, namely, the Japan Trauma Data Bank (JTDB), and only included patients aged ≥ 18 years with blunt severe abdominal trauma, defined as an AIS score of abdomen ≥ 3, sustained between 2004 and 2017. Patients without ACS were used as control subjects and identified using propensity score (PS) matching. Characteristics and outcomes between patients with and without ACS were compared and logistic regression was used to identify specific risk factors for ACS. RESULTS: Among 294,274 patients in the JTDB, 11,220 were eligible for inclusion before PS matching, and 150 (1.3%) developed ACS after trauma. PS matching led to the inclusion of 131 and 655 patients with and without ACS, respectively. Compared to controls, patients with ACS had higher number of injured organs in the abdomen and displayed a greater frequency of vascular and pancreatic injuries, need for blood transfusion, and disseminated intravascular coagulopathy, a complication of ACS. In-hospital mortality was higher in patients with ACS than those without ACS (51.1% vs. 26.0%, p < 0.01). Logistic regression analysis revealed that a higher number of injured organs in the abdomen [odds ratio (OR) (95% confidence interval [CI]): 1.76 (1.23–2.53)] and pancreatic injury [OR (95% CI): 1.53 (1.03–2.27)] were independently associated with ACS. CONCLUSIONS: Greater number of injured organs in abdomen and pancreatic injury are independent risk factors for the development of ACS. Public Library of Science 2023-05-23 /pmc/articles/PMC10204983/ /pubmed/37220117 http://dx.doi.org/10.1371/journal.pone.0286124 Text en © 2023 Komori et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Komori, Akira Iriyama, Hiroki Kainoh, Takako Aoki, Makoto Abe, Toshikazu Association between intra-abdominal injured organs and abdominal compartment syndrome in patients with severe blunt trauma: A propensity score matched study using nationwide trauma registry in Japan |
title | Association between intra-abdominal injured organs and abdominal compartment syndrome in patients with severe blunt trauma: A propensity score matched study using nationwide trauma registry in Japan |
title_full | Association between intra-abdominal injured organs and abdominal compartment syndrome in patients with severe blunt trauma: A propensity score matched study using nationwide trauma registry in Japan |
title_fullStr | Association between intra-abdominal injured organs and abdominal compartment syndrome in patients with severe blunt trauma: A propensity score matched study using nationwide trauma registry in Japan |
title_full_unstemmed | Association between intra-abdominal injured organs and abdominal compartment syndrome in patients with severe blunt trauma: A propensity score matched study using nationwide trauma registry in Japan |
title_short | Association between intra-abdominal injured organs and abdominal compartment syndrome in patients with severe blunt trauma: A propensity score matched study using nationwide trauma registry in Japan |
title_sort | association between intra-abdominal injured organs and abdominal compartment syndrome in patients with severe blunt trauma: a propensity score matched study using nationwide trauma registry in japan |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204983/ https://www.ncbi.nlm.nih.gov/pubmed/37220117 http://dx.doi.org/10.1371/journal.pone.0286124 |
work_keys_str_mv | AT komoriakira associationbetweenintraabdominalinjuredorgansandabdominalcompartmentsyndromeinpatientswithsevereblunttraumaapropensityscorematchedstudyusingnationwidetraumaregistryinjapan AT iriyamahiroki associationbetweenintraabdominalinjuredorgansandabdominalcompartmentsyndromeinpatientswithsevereblunttraumaapropensityscorematchedstudyusingnationwidetraumaregistryinjapan AT kainohtakako associationbetweenintraabdominalinjuredorgansandabdominalcompartmentsyndromeinpatientswithsevereblunttraumaapropensityscorematchedstudyusingnationwidetraumaregistryinjapan AT aokimakoto associationbetweenintraabdominalinjuredorgansandabdominalcompartmentsyndromeinpatientswithsevereblunttraumaapropensityscorematchedstudyusingnationwidetraumaregistryinjapan AT abetoshikazu associationbetweenintraabdominalinjuredorgansandabdominalcompartmentsyndromeinpatientswithsevereblunttraumaapropensityscorematchedstudyusingnationwidetraumaregistryinjapan |