Open AccessSelf‐Inflicted Abdominal Stab Wounds Have a Higher Rate of Non‐therapeutic Laparotomy/Laparoscopy and a Lower Risk of Injury
Author(s) -
Bugaev Nikolay,
McKay Kevin,
Breeze Janis L.,
Arabian Sandra S.,
Rabinovici Reuven
Publication year - 2017
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-017-4083-7
Subject(s) - medicine , glasgow coma scale , abdominal surgery , laparotomy , blood pressure , vascular surgery , laparoscopy , stab , surgery , cardiac surgery
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.