High PATI Score is Associated with Increase Mortality in Patients with Penetrating Abdominal Injuries; A Retrospective Review
Keywords:Penetrating abdominal index score, injury severity score, trauma and injury severity score
ABSTRACT: Background: Worldwide, injuries due to violence constitute eighth leading cause of death. Penetrating abdominal injuries account for third most common area involved. In literature PATI has been utilized to estimate the severity of abdominal trauma, decision making regarding repairing the damage and even risk of post-operative complications. We aimed and intended to use PATI score (penetrating abdominal trauma index) as a more accurate method of quantifying the extent of damage in patients with the penetrating abdominal trauma and association of high PATI score (>25) with mortality. Objective: To determine the association of mortality in patient with penetrating abdominal trauma with high PATI score (more than 25). Methods and Design: Medical records of all adult patients (age more than 16 years of age) admitted at Aga Khan University and Hospital with penetrating abdominal injuries from 2006 - 2012 were reviewed retrospectively; adult patients with complete medical records were included and patients with missing data were excluded from the study. SPSS version 19 was used for data entering and statistical analysis. Results: We included 74 patients, mostly men (95.9%), with a mean age of 34.4 +/- 11.9 years. Gunshot injuries accounted in 63 patients. Majority of the patients (31.1%) presented with grade 2 shock. Emergency laparotomies were done in 62 patients, 4 patients underwent damage control laparotomies. Seven patients were treated conservatively. Most commonly injured intraabdominal organ was small bowel (31%). Mean injury severity score was 12.97, mean revised trauma score was 7.63, and
mean TRISS was 96.19. Mean PATI Score was 10.85 +/- 8.9. Mortality occurred in 9 patients, among them four patient had
PATI score more than 25 (p=0.021). There is a seven time increase in risk of mortality in patients with high PATI score. Conclusion: Gunshots are mainly responsible for penetrating abdominal injuries in our study. Management was by mandatory laparotomy after clinical assessment, in majority of patients. PATI score is a valuable scoring for estimation of severity of penetrating abdominal injury in context with the outcome.