Multivariate analysis of patients with blunt trauma and possible factors affecting mortality

Abstract

BACKGROUND: This study aimed to investigate the signs and prognosis of the patients hospitalized due to blunt trauma injuries and identify possible factors that affect mortality. METHODS: Between January 2009 and January 2013, a total of 237 patients admitted with blunt trauma injury were retrospectively analyzed. The age and gender of the patients, type of the trauma, injury site, Injury Severity Scores (ISS), Revised Trauma Scores (RTS), Focused Assessment with Sonography in Trauma (FAST) results, hemodynamic status, need for transfusion, treatment modalities, treatment outcomes, and mortality rates were recorded. RESULTS: Of the patients, 187 (78.9%) were male, 50 (21.1%) were female and mean age was 36.9 +/- 16.9 years (3-81 years). Of the patients, 131 (55.3%) suffered thoracic injuries, 110 (46.6%) abdominal injuries, 96 (40.5%) pelvic and limb injuries, 34 (14.3%) head and neck injuries, 26 (11%) maxillofacial injuries, and 24 (10.1%) skin and subcutaneous tissue injuries. Forty-five patients (19%), including 33 patients with hemodynamic instability and 12 patients with peritonitis-related signs, were operated on. Mortality was seen in 26 patients (11%), including 10 (38.5%) with unstable pelvic fractures. Mortality rates; in patients with packing performed was 75%, in patients without any need for packing was 33.3%, in patients with hemodynamic instablity was 60.6%, in hemodynamically stable patients was 8.3% and in FAST (+) patients was 20.5%, in FAST(-) patients was 3.4% (p<0.05). CONCLUSION: Blunt trauma often presents with multi-trauma involving more than one anatomical structure of the body. Thoracic, abdominal, and pelvic injuries usually accompany blunt trauma. The majority of abdominal solid organ injuries are followed nonoperatively. Our study results show that ISS, RTS, FAST result, hemodynamic unstability, packing requirment, and need for transfusion are statistically invaluable in identifying the mortality risk.