1. Thoracoabdominal shotgun wounds: an evaluation of factors associated with the need for surgical intervention.
- Author
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Carrick MM, Morrison CA, Alexis DJ, Feanny MA, Pham HQ, Welsh FJ, Norman MA, and Scott BG
- Subjects
- Abdominal Injuries mortality, Abdominal Injuries surgery, Adult, Female, Follow-Up Studies, Humans, Male, Retrospective Studies, Risk Factors, Survival Rate trends, Texas epidemiology, Thoracic Injuries mortality, Thoracic Injuries surgery, Trauma Centers, Trauma Severity Indices, Urban Population, Wounds, Gunshot mortality, Wounds, Gunshot surgery, Abdominal Injuries diagnosis, Decision Making, Laparotomy, Multiple Trauma, Thoracic Injuries diagnosis, Thoracotomy, Wounds, Gunshot diagnosis
- Abstract
Background: Shotgun wound classification systems attempt to predict the need for surgical intervention based on the size of wounds, pellet spread, or distance from the weapon rather than clinical findings., Methods: A 5-year retrospective review of patients sustaining a thoracoabdominal shotgun wound was performed. Factors believed to be associated with the need for surgical intervention were examined using the Fisher exact test or an independent sample t test., Results: Sixty-four patients suffered a thoracoabdominal shotgun wound. Fifty-nine percent required surgical intervention. Factors significantly associated with the need for surgical intervention were a low revised trauma score and systolic and diastolic blood pressure (P < .05). Distance from attacker, wound patterns, pellet size, and pellet spread were not found to have an association., Conclusions: Clinical indicators of hemorrhage and shock are associated with the need for surgical intervention, whereas pellet spread, pellet size, and distance from the attacker are not. This is a significant departure from traditional classification systems.
- Published
- 2009
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