Use of a severity index to measure prognosis in penetrating abdominal trauma

Abstract

During the last ten years there has been an alarming increase in the amount and severity of trauma in Colombia which has overcome the physical and human resources at all hospitals rendering them insufficient. Between September 1, 1986 and January 31, 1987, we applied the index of Penetrating Abdominal Trauma, described by Moore In 1981, to 140 patients admitted to Hospital Universitario San Vicente de Paúl, Medellín, Colombia. The purpose was to develop a tool that allowed us to classify the severity of trauma and to adequately triage the patients and allocate the necessary resources for their care. Nevertheless, in our hands, this scale was not found to be predictive because It could not discriminate between groups of patients at high risk for major or minor complications. For this reason we decided to analize the variables that determine the prognosis of patients with penetrating abdominal trauma and the following ones were found to have prognostic significance: degree of abdominal cavity contamination (p=0.0001 ), length of time between accident and hospital admission (p=0.01) and the presence of shock (p=0.01 ).

Based on these variables and on the Moore Index a new scale was designed: we called It Modified Moore Scale and It was found to be highly significant to predict which patients were at high risk of developing major (p=0.003) as well as minor (p=0.015) complications. We estimate that this scale should be taken into consideration when making clinical decisions and when designing research protocols In patients with penetrating abdominal trauma.