Patterns, outcomes, and associated factors of Penetrating Abdominal Injury at Addis Ababa Burn Emergency And Trauma Hospital Adult Emergency Department

Abstract

Abstract Background: The most common causes of PAI are gunshots and stabbings. Stab wounds (SW) occur three times as frequently as gunshot wounds (GSW), but have a lower mortality rate due to the lower energy transmitted. GSW is responsible for approximately 90% of deaths caused by penetrating abdominal injury (PAI). Objectives: To assess the pattern, outcome and associated factors of PAI among patient admitted at AaBET Hospital. Methods: An institution-based cross-sectional study was conducted from September 1, 2020 to October 1, 2023. A standard checklist was used to review the clinical charts of all patients admitted with PAI at AaBET Hospital ED. A total of 178 patients with penetrating abdominal injury who met the inclusion criteria were included. Patients' characteristics were described using descriptive statistics. Bivariate and multivariate logistic regression analyses were used to identify the factors associated with PAI treatment outcomes. Adjusted odds ratios (AORs) were calculated and statistical significance was determined at a P-value of 0.05. Result: A total of 178 charts of patients with PAI were reviewed. The commonest mechanism of injury was stab injury occurring in 110 cases (61.8%) ,followed by bullet injuries in 63 cases (35.4%). The majority of the 95 (53.4%) study subjects were between the ages of 25 and 44. Males accounted for 89.9% of the study subjects, and rural residents made up 73.6%. The majority of our patients were managed conservatively (69.1%), however (30.9%) underwent exploratory laparotomy. Overall mortality was 5.6%. In this study, factors that determined mortality included age > 45 (AOR= 9.84 (95%CI: 1.69, 57.4), bullet injuries (AOR = 4.99 (95% CI: 1.13, 25.19), associated SCI (AOR = 12.20 (95% CI: 1.106, 134.44), and the presence of MODS (AOR = 373.86.20 (95% CI: 14.01, 942.92). Conclusion: The most common mechanism of PAI among young adult males was stab injury. Mortality was associated with age above 45, bullet mechanism of injury, associated extraabdominal injury, and presence of MODS. Ninety percent of penetrating abdominal injuries (PAI) deaths are due to bullet injuries, indicating the necessity of strictly enforcing the laws limiting the use of weapons in our nation. KEY WORDS: Penetrating abdominal injuries, clinical patterns, associated factors, Outcomes, Ethiopia.