Abstract

Background: Injuries due to violence is the eighth leading cause of death worldwide. Penetrating abdominal trauma is the third most common area involved. PATI has been used to estimate the severity of abdominal trauma and as a prognostic factor in assessing the mortality rates and commencing the treatment modality regarding repairing the damage and even risk of post-operative complications. The aim of the study is to prove the significance of PATI score (penetrating abdominal trauma index) in assessing the mortality and morbidity in patients with penetrating abdominal injury.

Objective: To assess and determine the association of mortality in patients with penetrating abdominal trauma with high PATI score (more than 25).

Methods and Design: Case details of all patients (age more than 16 years of age) admitted at Rajah Muthiah Medical College, Annamalai University, Chidambaram with penetrating abdominal injuries from 2008 - 2018 were reviewed retrospectively and prospectively and; adult patients with complete case details were included and patients with missing data were excluded from the study.

Results: We included 40 patients in our case study. Stab injuries accounted for about 24 cases followed by bull gore injury⁷ (7). Male incidence was 70%. The most common age group affected were between 21 and 30 years.

Ten patients were treated conservatively who were hemodynamically stable and without signs of peritonism. 30 patients underwent laparotomy and in 5 patients negative laparotomy was encountered. Small bowel was the most commonly injured organ in our study followed by liver and spleen. The mortality rate were 2 among the 30 laparotomised patients. The optimum duration of hospital stay was 10 days. Patients with PATI score of more than 20 were at the risk and were given ICU care. So PATI score is valuable in assessing the mortality and morbidity in patients with penetrating abdominal trauma.

Conclusion: Stab injuries are responsible for 60% of penetrating abdominal injuries in our study.¹⁵ Management was by emergency laparotomy after clinical assessment, in majority of patients. PATI scoring is of great value in estimating the severity of penetrating abdominal injury and in assessing the mortality rates.