Independent risk factors of morbidity in penetrating colon injuries

BACKGROUND
The present study explored the factors effective on colon-related morbidity in patients with penetrating injury of the colon.
METHODS
The medical records of 196 patients were reviewed for variables including age, gender, factor of trauma, time between injury and operation, shock, duration of operation, Penetrating Abdominal Trauma Index (PATI), Injury Severity Score (ISS), site of colon injury, Colon Injury Score, fecal contamination, number of associated intra- and extraabdominal organ injuries, units of transfused blood within the first 24 hours, and type of surgery. In order to determine the independent risk factors, multivariate logistic regression analysis was performed.
RESULTS
Gunshot wounds, interval between injury and operation ≥6 hours, shock, duration of the operation ≥6 hours, PATI ≥25, ISS ≥20, Colon Injury Score ≥ grade 3, major fecal contamination, number of associated intraabdominal organ injuries >2, number of associated extraabdominal organ injuries >2, multiple blood transfusions, and diversion were significantly associated with morbidity. Multivariate logistic regression analysis showed diversion and transfusion of ≥4 units in the first 24 hours as independent risk factors affecting colon-related morbidity.
CONCLUSION
Diversion and transfusion of ≥4 units in the first 24 hours were determined to be independent risk factors for colon-related morbidity.

Penetran kolon yaralanmalarýnda morbiditeye etkili baðýmsýz risk faktörleri

AMAÇ
Penetran kolon yaralanmalý hastalarda, kolon ile iliþkili morbiditeye etkili faktörler deðerlendirildi.
GEREÇ VE YÖNTEM
Hastalarýn (n=196) medikal kayýtlarýndan yaþ, cinsiyet, travma etkeni, travma operasyon entervali, þok, ameliyat süresi, Penetran Abdominal Travma Ýndeksi (PATÝ), yaralanma þiddeti ölçeði (ISS), yaralanan kolon segmenti, kolon yaralanma skoru, fekal kontaminasyon, ilk 24 saat içinde yapýlan kan transfüzyonu, intra ve ekstra-abdominal yandaþ yaralanan organ sayýsý ve cerrahi þeklini içeren deðiþkenler incelendi. Baðýmsýz risk faktörlerini saptamak amacýyla bu deðiþkenlere multivaryant lojistik regresyon analizi uygulandý.
BULGULAR
Ateþli silah yaralanmasý, travma ameliyat entervalinin ≥6 s, þok varlýðý, ameliyat süresi ≥6 s, PATÝ ≥25, ÝSS ≥20, kolon yaralanma skoru ≥3, majör fekal kontaminasyon, karýniçi yandaþ yaralanan organ sayýsý >2, ekstra-abdominal yandaþ yaralanan organ sayýsý >2, multipl kan transfüzyonunun yapýlmasý ve diversiyon uygulanmýþ olmasý morbiditeyle iliþkisi anlamlý bulundu. Multivaryant analiz, ilk 24 saat içinde yapýlan kan transfüzyon sayýsýnýn ≥4 olmasý ve diversiyon uygulamasýnýn penetran kolon yaralanmalarýnda kolon iliþkili morbitite geliþimi üzerine etkili baðýmsýz risk faktörleri olduðunu gösterdi.
SONUÇ
Kolon iliþkili morbidite geliþimi üzerine etkili baðýmsýz risk faktörleri; ilk 24 saat içinde yapýlan kan transfüzyon sayýsýnýn ≥4 olmasý ve diversiyon olarak belirlendi.