Self-Inflicted Abdominal Stab Wounds Have a Higher Rate of Non-therapeutic Laparotomy/Laparoscopy and a Lower Risk of Injury.

Abstract:

BACKGROUND:The profile and management of self-inflicted abdominal stab wounds (SI-ASW) patients is still obscure. METHODS:The National Trauma Data Bank (2012) was queried for adults with abdominal stab wounds (n = 9544). Patients with SI-ASW (n = 1724) and non-SI-ASW (n = 7820) were compared. Predictors for non-therapeutic laparotomy/laparoscopy (non-TL) in SI-ASW patients were identified. RESULTS:SI-ASW patients were older, had more females and behavioral disorders, similar physiology, but a lower Injury Severity Score. They had more laparotomies overall (54 versus 48%, p < 0.0001) and more non-TL (42 versus 32%, p < 0.0001), but less injuries (43 versus 53%, p < 0.0001), although peritoneal violation rate was similar. Complications and mortality were similar. In the SI-ASW cohort, non-TL patients were more likely to be female and younger, and to have Glasgow Coma Scale (GCS) ≥13 and a higher systolic blood pressure. History of psychiatric, drug and alcohol disorders was associated with SI-ASW, but did not independently predict the need for treatment in adjusted models. CONCLUSION:Patients with SI-ASW underwent more non-TL than patients with non-SI-ASW. Female gender, younger age, and a higher GCS and systolic blood pressure predicted non-TL in this group.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Bugaev N,McKay K,Breeze JL,Arabian SS,Rabinovici R

doi

10.1007/s00268-017-4083-7

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

2681-2688

issue

11

eissn

0364-2313

issn

1432-2323

pii

10.1007/s00268-017-4083-7

journal_volume

41

pub_type

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