Objectives: To evaluate outcome of blunt trauma patients (TP) in relation to body region maximally injured, line of management and site of provision of treatment. Also, to evaluate at admission serum interleukin-6 (IL-6), macrophage migration inhibitory factor (MIF) and syndycan1 (Synd1) levels as outcome predictors.
Patients & Methods: 124 blunt TP were clinically evaluated to determine the Injury Severity Score (ISS). Patients requiring intensive care, surgical intervention, or both were followed up for development of complications and discharge, alive (Survivors) or dead (Non-survivors). At admission blood sample was withdrawn for ELISA estimation of serum levels of studied parameters. Outcomes included morbidity and mortality rates (MR) and its relation to admission data.
Results: Total MR was 25%. ICU admission rate was 63.7% and ICU-MR was 34.2%. MR according to body region with the highest ISS was 13.6%, 18.2%, 33.3% and 16.7% for brain, chest, abdominal and retroperitoneal injury. Forty-four TP received non-operative management (NOM), 35 TP undertook emergency and 45 had elective surgeries and management-related MR was 11.4%, 38.7% and 31.1% with significantly higher MR among patients undertook surgery versus NOM. Non-survivors were significantly older and obese with significantly higher ISS and showed significantly higher morbidities and serum IL-6, MIF-1 and Sydn1 levels than in survivors. Statistical analyses defined high serum levels of IL-6, SDN1 and MIF1, undertaking emergency surgery and high BMI as negative predictors for survival.
Conclusion: Blunt trauma is still a health problem with heavy burden on hospital resources secondary to high ICU admission rates, need for operative interference and high morbidity and MR. NOM is appropriate line of management to spare surgery whenever possible. Respiratory complications are the most pronounced ICU event with ARDS is the most common. At admission estimation of serum levels of the studied parameters could help management decision-making.
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