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Incidence of Hollow Viscus Injury in Blunt Trauma: An Analysis from 275,557 Trauma Admissions from the EAST Multi-Institutional Trial

Watts, Dorraine D. PhD, RN; Fakhry, Samir M. MDfor the EAST Multi-Institutional HVI Research Group

The Journal of Trauma: Injury, Infection, and Critical Care: February 2003 - Volume 54 - Issue 2 - p 289-294
doi: 10.1097/01.TA.0000046261.06976.6A
Original Articles
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Background  Blunt hollow viscus injury (HVI) is uncommon. No sufficiently large series has studied the prevalence of these injuries in blunt trauma patients. This study defines the prevalence of blunt HVI, in addition to the associated morbidity and mortality rates for this diagnosis on the basis of a series of over 275,000 trauma admissions.

Methods  Patients with blunt small bowel injury (SBI) were identified from the registries of 95 trauma centers for a 2-year period (1998–1999). Each HVI patient (case) was matched by age and Injury Severity Score with a blunt trauma patient receiving an abdominal workup who did not have HVI (control). Patient level data were abstracted by individual chart review. Institution level data were collected on total numbers for trauma admission demographics and on total diagnostic examinations performed.

Results  From 275,557 trauma admissions, 227,972 blunt injury patients were identified. HVI was rare, with 2,632 patients identified from this group. Perforating small bowel injury accounted for less than 0.3% of blunt admissions. Mortality and morbidity were high for HVI. Controlling for injury severity, patients with HVI were usually at higher risk of death than non-HVI patients.

Conclusion  HVI is a rare but deadly phenomenon. The high mortality rates reflect the severity of the HVI and associated injuries. HVI patients should be carefully monitored for related injuries and complications.

From the Inova Regional Trauma Center, Inova Fairfax Hospital, Falls Church, Virginia.

Submitted for publication July 3, 2002.

Accepted for publication October 21, 2002.

Presented, in part, as a plenary session at the 15th Annual Meeting of the Eastern Association for the Surgery of Trauma, January 16–19, 2002, Orlando, Florida.

Address for reprints: Dorraine D. Watts, PhD, RN, Inova Regional Trauma Center, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042-3300.

© 2003 Lippincott Williams & Wilkins, Inc.