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Patients with abdominal trauma at risk for intra-abdominal infections following surgery

CHICAGO Patients who undergo surgery for abdominal trauma caused by firearm wounds or by blunt trauma are at risk for developing intra-abdominal infections, and several factors increase that risk, according to a study in the December issue of The Archives of Surgery, one of the JAMA/Archives journals.

According to background information in the article, "Infection is responsible for most deaths in trauma patients who survive longer than 48 hours after trauma. Intra-abdominal infection (organ/space surgical site infection) in patients with abdominal trauma constitutes one of the most frequent infectious problems and poses a major challenge to trauma surgeons." The authors write that the incidence of these infections ranges from 2 percent to 9 percent and that the death rate from intra-abdominal infection can be higher than 50 percent if the diagnosis is delayed after development of multiple organ failure.

Carlos H. Morales, M.D., M.Sc., from Universidad de Antioquia, Medellin, Colombia, and colleagues analyzed the records of 762 patients with abdominal trauma who underwent surgery and were admitted to a level I trauma center in Medellin between November 1, 2000 through August 31, 2002. The majority of the patients were male (91.2 percent) and the average age was 27.9 years. The researchers were seeking information on the incidence of intra-abdominal infection and the risk factors associated with the development of this complication.

The researchers note, "A higher risk of intra-abdominal infection was found in patients with penetrating trauma due to firearm wounds or with blunt trauma, compared with those wounded by stabbing." "Intra-abdominal infection developed in 81 patients (10.6 percent)," the researchers found. Their analysis revealed that the likelihood of infection increased with more severe wounds, "contamination of the abdominal cavity, and admission to the intensive care unit as independent risk factors for the deve
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Contact: Carlos H. Morales, M.D., M.Sc.
cmorales@epm.net.co
JAMA and Archives Journals
20-Dec-2004


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