Description

Demetriades et al separated patients with penetrating colon injuries into high and low risk groups shortly after admission. This can help identify those patients who may require more aggressive management and monitoring. The authors are from multiple trauma centers from across the United States, Columbia and South Africa.


 

Parameters:

(1) systolic blood pressure on admission

(2) blood transfusion preoperatively and intraoperatively (see Table 9, page 771)

(3) penetrating abdominal trauma index (PATI, see above)

(4) delay in surgery (based on hours from injury, see Table 9, page 771)

(5) fecal contamination

Parameter

Findings

Points

systolic blood pressure on admission

not hypotensive

0

 

hypotensive (systolic blood pressure < 90 mm Hg)

1

blood transfusion

<= 6 units

0

 

> 6 units

1

PATI index

<= 25

0

 

> 25

1

number of hours from injury

<= 6 hours

0

 

> 6 hours

1

fecal contamination

none to moderate

0

 

severe

1

 

total number of risk factors =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 5

 

Number of Risk Factors

Risk Group

0

low risk

>= 1

high risk

 


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