90th Annual Meeting Abstracts
Colorectal Trauma: An Outcome Analysis
*Tiffany Fancher, *Marisa Formica, BA, *Michael S Ajemian, MD
St. Mary's Hospital, Waterbury, CT
Introduction: The objective of this study was to compare blunt and penetrating colorectal injuries from the national trauma database (NTD).
Methods: Investigation of the NTD revealed 601 patients with injuries to the colon or rectum requiring operative repair from 2002-2007. Outcomes evaluated included; demographics, injury endured, operation performed, time to operating room, Injury Severity Score (ISS), AAST Colon Injury Scale (CIS), length of stay, complications and mortality.
Results: The majority of the selected patients were male (85%) with an average age of 33. Penetrating injuries were more common than blunt injury (66% vs 34%). The ISS (23.8 vs 16.7) and mortality (13% vs 8%) were significantly higher for the patients with blunt trauma compared with penetrating trauma (p<.005). Despite having a higher percent of positive documented fasts (16% vs 4%), blunt trauma patients took significantly longer than penetrating patients to get to the operating room (17 vs 9.7 hours, p<0.005). The average CIS of 1.77 was lower for blunt trauma when compared with penetrating trauma 2.03. Of the 90 patients that underwent a colostomy, 64% had penetrating wounds. There were significantly more complications in the blunt colorectal trauma injuries undergoing primary repair (17% vs 4%) when compared with the penetrating trauma group.
Conclusion: Blunt colorectal injuries had a significantly longer observation period prior to operation, a longer length of stay and a higher mortality. While blunt trauma has a lower CIS, there are a great number of associated injuries and complications. Diversion should be considered in patients that suffer a colorectal injury from blunt trauma.