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Abstract
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OBJECTIVE Road traffic accidents (RTA) are the first cause of abdominopelvic injuries (API). The objective of this study was to describe the characteristics and severity of API due to traffic accidents in a large French trauma registry and to identify risk factors for API.
METHODS All victims from the French Rhône registry of victims of RTA were analyzed from 1996 to 2013. This registry contained data that were issued over a 20-year period from 245 medical departments, from prehospital care until re-adaptation, and forensic medicine departments. All API, defined as an injury between the diaphragm and the pelvic bone, were extracted and studied.
RESULTS Among 162,695 victims, 10,165 had an API (6.7%). Accidents frequently involved young men and two cars. Mean Injury Severity Score (ISS) was 8.7. Mortality rate was 5.6%. Soft tissue injuries largely predominated (n = 6388; 54.4% of patients). Overall, 2322 victims had a pelvic bone injury. Internal abdominal organs were involved in 2425 patients; the most frequent were the spleen, liver, and kidney. Wearing of the seat belt appeared to be a significant protective factor in API, including serious injuries. A partial analysis over the past 2 years among the most severe patients hospitalized in the intensive care unit indicated that nonoperative management was carried out in two thirds of the wounded. In uni- or multivariate analysis, sex, age, type of user, antagonist, time of occurrence, associated severe lesions, or wearing of the seat belt were statistically associated with the occurrence of API, highlighting a more dangerous user profile.
CONCLUSIONS Abdominopelvic injuries concern a minority of road traffic injuries, but they are responsible for a significant overmortality. Large solid organs are the most frequently affected. Women car users, wearing the seat belt, driving in town during the day appear to be more protected against API.
Language: en |