[Hollow Organ Injury and Multiple Trauma: Treatment, Course and Outcome - An Organ-Specific Evaluation of 1127 Patients from the Trauma Registry of the DGU.]

Abstract

Background: The relevance of hollow organ trauma in severely injured patients within a large collective has not been thoroughly reviewed as yet. This study aimed at assessing the prevalence of hollow organ trauma in relation to the outcome and the currently established method of treatment. Patients and Methods: Altogether data of all patients of the Trauma Register of the German Society of Trauma Surgery (DGU) (1993 - 2009) were interpreted retrospectively. All patients with an "Injury Severity Score" (ISS) ≥ 16, direct admission to a trauma centre and an age of ≥ 16 years were included. All patients with abdominal trauma (AISabdomen ≥ 2) were compared with patients with hollow organ trauma (AIShollow organ ≥ 2). The following organs were attributed to the hollow organs: stomach, small intestine (duodenum, jejunum / ileum), colon, gall bladder and urinary bladder. Results: From 9268 patients with abdominal injuries 1127 (12.2 %) additionally showed a hollow organ injury (AISabdomen ≥ 2, AIShollow organ 2 - 5) and were analysed in dependence on the classification of the "American Association for the Surgery of Trauma" (AAST) organ severity score. AAST-hollow organ: II°: 4.6 %, III°: 5.3 %, IV°: 2.1 %, V°: 0.2 %. Patients with leading hollow organ injury (grades IV and V) thereby showed a significant increase of lethality (IV°: 32.7 % and V°: 31.3 %). With an increasing grade of hollow organ injury, however, the ISS increased as well. Lethality was not increased over the expected lethality rate (RISC score) due to the additional hollow organ injury though. Conclusion: The results presented here show the prevalence and the outcome of hollow organ injury in a large collective within the Trauma Register of the DGU for the first time.