The incidence of abdominal injury in patients with thoracic and/or pelvic trauma

Abstract

Summary Aims: Clinically and intuitively, it is believed that the incidence of abdominal injuries is high when there is a combination of both thoracic and pelvic trauma. The aim of this study was to establish the true incidence of intra-abdominal injury in these patients. Methods: A retrospective analysis of the Scottish Trauma Audit Group (STAG) database for the 5-year period from 1997 to 2001 inclusive. Significant chest, abdominal and pelvic injuries were all defined as AIS ≥ 2. The incidence of abdominal trauma was calculated for different combinations of severity of chest and/or pelvic trauma. Results: 507/3644 (14%) patients with significant chest trauma but no pelvic trauma had concomitant abdominal injuries, compared to 111/1397 (8%) patients with pelvic trauma but no chest trauma. The likelihood of concomitant abdominal injury increased significantly if both chest and pelvis injuries were present (239/507, 47%; p Amongst patients with combined chest and pelvic trauma, the incidence of abdominal injury increased with severity of pelvic and chest injury (pelvis and chest both AIS = 2: 5/45, 11%; either pelvis or chest AIS = 3+: 81/198, 41%; both pelvis and chest AIS = 3+: 153/264, 58%; p Conclusion: As expected, patients with serious chest and pelvic trauma have a much higher incidence of significant abdominal injury than patients with chest or pelvic trauma in isolation. Where laparotomy is not immediately indicated, imaging should be considered mandatory.