Factors affecting survival of children after abdominal trauma in Lebanese civil war

Abstract

To evaluate the risk factors affecting the survival of children with war injuries involving the abdomen, 270 children under 16 years of age with abdominal injuries during the civil war in Lebanon were studied. One hundred and ninety (70%) sustained penetrating injuries and 80 (30%) blunt trauma. The overall infection rate was 7.8%. There were 13 deaths (4.8%), 7 early and 6 late. Mortality was higher in patients with shock on admission than in those without shock (P = .009). Multiple logistic-regression analysis showed that inadequate initial treatment requiring a second laparotomy (P = .01), severe hypovolemia requiring large blood transfusions (P = .0001), and multiple intra-abdominal injuries (P = .001) were the three independent risk factors that influenced the outcome of treatment. Wound infection was associated with a higher mortality in patients with penetrating injuries (P = .0001). This study suggests that in children with war injuries involving the abdomen, multiple injuries associated with excessive bleeding led to early death and wound infection in penetrating injuries to late death.