Indications for an Immediate Laparotomy in Patients with Abdominal Stab Wounds
Journal of the Korean Society of Traumatology
; : 106-114, 2007.
Article
в Ko
| WPRIM
| ID: wpr-78119
Ответственная библиотека:
WPRO
ABSTRACT
PURPOSE: There is little controversy that a classic indication such as hemodynamic instability or any sign of peritoneal irritation requires an immediate laparotomy in the management of abdominal stab wounds. However, omental herniation or bowel evisceration as an indication for an immediate laparotomy is controversial. The purpose of this study was to evaluate the significance of these factors as indications for an immediate laparotomy. METHODS: The medical records of 98 consecutive abdominal stab wounds patients admitted to the Emergency Center of Masan Samsung Hospital from January 2000 to December 2006 were carefully examined retrospectively. Using multivariate logistic regression analysis, thirty-nine factors, including the classic indication and intraabdominal organ evisceration, were evaluated and were found to be associated with a need for a laparotomy. Also, the classic indication was compared with a new indication consisting of components of the classic indication and intra-abdominal organ evisceration by constructing a contingency table according to the need for a laparotomy. RESULTS: Multivariate logistic regression analysis revealed any sign of peritoneal irritation, base deficit, and age to be significant factors associated with the need for a laparotomy (p<0.05). The sensitivity, specificity, and accuracy rates of the classic indication were 98.6%, 72.0%, and 91.8%, respectively, and those of the new indication were 93.2%, 84.0%, and 90.8%, respectively. The differences in those rates between the above two indications were not significant. CONCLUSION: Intra-abdominal organ evisceration was not a significant factor for an immediate laparotomy. Moreover, the new indication including intra-abdominal organ evisceration was not superior to the classic indication. Therefore, in the management of abdominal stab wounds, the authors suggest that an immediate laparotomy should be performed on patients with hemodynamic instability or with any sign of peritoneal irritation.
Key words
Полный текст:
1
База данных:
WPRIM
Основная тема:
Wounds, Stab
/
Logistic Models
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Medical Records
/
Retrospective Studies
/
Sensitivity and Specificity
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Emergencies
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Abdomen
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Hemodynamics
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Laparotomy
Тип исследования:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Пределы темы:
Humans
Язык:
Ko
Журнал:
Journal of the Korean Society of Traumatology
Год:
2007
Тип:
Article