Citation

Brady RR, O'Neill S, Berry O, Kerssens JJ, Yalamarthi S, Parks RW. Colorectal Dis. 2012; 14(1): e16-22.

Affiliation

Department of Surgery, Queen Margaret Hospital, NHS Fife ISD, NHS Scotland Department of Surgery Edinburgh Royal Infirmary, Little France, Edinburgh.

Copyright

(Copyright © 2012, John Wiley and Sons)

DOI

10.1111/j.1463-1318.2011.02753.x

PMID

21831191

Abstract

Aim:  Colorectal trauma comprises less than 1% of trauma cases but is associated with significant morbidity and mortality. In order to establish the contemporary epidemiology of colorectal trauma in Scotland and to detect risk factors associated with patient outcomes, an analysis of a multi-centered database of trauma patients was performed. Methods:  The study used data from a prospective multi-centre trauma database containing details of 52,887 trauma patients admitted to participating Scottish Hospitals over an 11-year period. Results:  340 (0.64%) of 52,887 trauma patients (284 male) with colorectal injuries were identified. 43.9% of colorectal injuries occurred following blunt trauma and 56.1% following penetrating injury. Patients in the latter group were younger, had less haemodynamic compromise and were less likely to die than those with blunt trauma (p<0.01). The overall mortality rate was 25.6% and after rectal injury it was 21.2% (p>0.05). Female gender, increased age, road traffic accidents and those admitted as a result of a blunt traumatic injury were associated with increased mortality. Age > 65 years (p=0.01), increasing injury severity score (ISS) at presentation (p<0.001), haemodynamic compromise (p=0.045) and decreased Glasgow Coma Score (GCS) (p<0.001) had the strongest independent associations with mortality. Conclusion:  Colorectal injury following trauma is rare but is associated with high mortality. Patient demographics and clinical variables strongly associated with fatal outcome are presented, allowing more accurate stratification of patient mortality risks.

Language: en