OUTCOME OF ABDOMINAL TRAUMA MANAGEMENT IN A LEVEL 1 TRAUMA CENTRE: 1-YEAR DESCRIPTIVE ANALYSIS

Abstract

Background: Abdominal trauma constitutes a substantial proportion of emergency surgical admissions and remains a leading cause of preventable mortality in high-volume trauma centres. A comprehensive evaluation of perioperative trends, operative findings, complications, and short-term outcomes is essential to optimise trauma care pathways and guide effective resource allocation, particularly in low- and middle-income settings. Objective: To describe peri-operative status, intra-operative findings, post-operative complications, in-hospital mortality, and 30-day clinical outcomes among patients presenting with abdominal trauma at a Level 1 trauma centre. Study Design: Descriptive observational cohort study. Settings: Shaheed Mohtarma Benazir Bhutto Trauma Centre, Karachi, Pakistan. Duration of Study: 1 January 2024 to 1 January 2025. Methods: A cohort of 100 patients presenting with abdominal trauma was analysed. Data collected included perioperative transfusion requirements and mortality; operative findings, such as gastrointestinal injury patterns and surgical procedures; intraoperative parameters; postoperative complications; length of hospital stay; and 30-day follow-up outcomes, including readmission, mortality, and functional recovery. Categorical variables were summarised as frequencies and percentages, while continuous variables were expressed as mean ± standard deviation. Results: Pre-operatively, 48% of patients required blood transfusion, with a mean transfusion volume of 1.17 ± 1.39 units. No pre-operative mortality was observed. Among operative patients (n = 63), minor bowel injuries (28%) and colonic injuries (19%) were the most frequent hollow viscus injuries. Primary repair was the most commonly performed procedure (34%), and no intraoperative mortality occurred. The mean arrival-to-surgery time was 2.94 ± 2.34 hours, the mean estimated blood loss was 840.51 ± 358.55 mL, and the mean intensive care unit stay was 1.65 ± 1.94 days. Post-operative complications occurred in 39% of patients, with surgical site infection being the most frequent (40%). In-hospital mortality was 8%, and the mean hospital stay was 9.99 ± 3.48 days. At 30-day follow-up, 10% of patients required readmission, no additional mortality was recorded after discharge, and 69% of patients returned to premorbid functional status. Conclusion: Abdominal trauma at a Level 1 trauma centre was associated with moderate post-operative morbidity, predominantly driven by infectious complications and a notable in-hospital mortality rate. Although most survivors achieved functional recovery, the observed outcomes highlight the need for targeted improvements in perioperative optimisation, infection prevention strategies, and structured post-discharge follow-up.