Abstract

The aim of the present study was to identify risk factors leading to mortality in cases of blunt abdominal trauma. Methods: The Hospital based Ambispective observational study was conducted in the Department of General surgery, PBMH, Kalinga Institute of Medical Sciences, Bhubaneswar with blunt abdominal trauma during the period September 2019 to August 2021. 81 patients were included in the study. Results: There were 46% (n=37) of the participants belonged to the age group 16 to 30 years and 22% (n=18) belonged to age group 46 to 60 years. Majority (n=94%, n=76 were males and rest 6% were females. There were 83% RTA cases, 10% fall from height cases, 5% fall from cycles and 2.5% assault cases. Almost 88% (n=71) were alive at the end of the study and 12% (n=10) died during the study period. About 36% (n=29) admitted between 6 to 12 hours of trauma, 24% admitted between 12 to 24 hours and 26% admitted after one day (>24hours). Among those had fell from height, 38% died and among those hand RTA, 11% died. There was no significant association between mode of injury and mortality (p=0.125). Among those who died (n=10), majority (60%, n=6) died due to septic shock and MODS, 20% (n=2) died due to hypovolemic shock and MODS. There was one death each (10%) due to brain damage and severe metabolic acidosis. Nearly 26% were grade 1 or 2 liver injuries, and 12% were grade 3 and above type of liver injury. About 15% were grade 1 or 2 splenic injury and 11% were grade 3 and above splenic injury. About 5% were grade 1 or 2 renal injury and 4% were grade 3 or above renal injury. Conclusion: BAT is most commonly caused by RTA in younger age group with male preponderance. Diagnosis and early intervention remains a key in saving lives in BAT. Most patients can be managed conservatively especially solid organ injury, it is the hollow viscus injury or haemodynamic instability due to ongoing hemorrhage require operative intervention.

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