Factors predicting the risk of intra-abdominal sepsis and burst abdomen in patients with abdominal trauma undergoing laparotomy

Abstract

AIM: This study aims to study the factors which predict the risk of intra-abdominal sepsis (IAS) and burst abdomen in patients with abdominal trauma undergoing laparotomy. MATERIALS AND METHODS: Seventy-five patients with abdominal trauma undergoing laparotomy were evaluated in pre-, intra-, post-operative period for factors such as injury severity score (ISS), abdominal trauma index (ATI), operative severity score (OSS), and intra-abdominal pressure (IAP). The correlation was found among these factors and risk of IAS and burst abdomen following laparotomy. RESULTS: Mean ATI, ISS, and OSS in IAS present and absent group were (35 ± 10 and 21 ± 7), (47 ± 16 and 22 ± 9), and (30 ± 6 and 18 ± 6), respectively. Mean ATI, ISS, and OSS in burst abdomen present and absent group were (35 ± 10 and 22 ± 8), (43 ± 14 and 23 ± 12), and (30 ± 6 and 19 ± 6) respectively. Mean IAP on D0, D1, and D2 in IAS present and absent group were (23 ± 7 mmHg and 16 ± 3 mmHg), (14 ± 4 mmHg and 7 ± 3 mmHg), and (11 ± 5 mmHg and 5 ± 2 mmHg), respectively. Mean IAP on D0, D1, and D2 in burst abdomen present and absent group were (23 ± 7 mmHg and 16 ± 3 mmHg), (13 ± 4 mmHg and 7 ± 4 mmHg), and (11 ± 5 mmHg and 5 ± 2 mmHg), respectively. Out of the 15 patients who had IAS, 13 also had burst abdomen. Significant correlation was found between ATI, ISS, and OSS with IAS and burst abdomen, and between IAS and burst abdomen. CONCLUSIONS: Higher scores of ATI, ISS, OSS, and IAP are associated with higher chance of developing IAS and burst abdomen in the postoperative period. The presence of one complication in the postoperative period increases the risk for the other. Therefore, we can have risk-based approach in managing the patients having above-mentioned risk factors.