Analysis of hollow visceral injuries admitted to a level one intensive care unit in South Africa

Abstract

Background: Bowel trauma, encompassing injuries to the small and large intestine, represents a significant medical challenge due to its potential for morbidity and mortality. Management of bowel injuries remains surgical, but multiple factors influence the outcome in these patients. This study provides an in-depth analysis of the high-risk features of hollow visceral trauma in the ICU setting and the corresponding mortality rates, shedding light on the critical factors that influence outcomes in these cases.

Methods: Retrospective review of patients admitted to the trauma intensive care unit (ICU) at Inkosi Albert Luthuli Hospital from January 2017 until September 2022 were reviewed to identify risk features associated with morbidity and mortality. Statistical analysis was performed using Python 3.10.

Results: Ninety-four patients were reviewed, the majority (88.3%) were male and median age was 31.5 years. Mortality was 31.9%. The median length of stay in the ICU was 9.0 days (IQR 4–19 days, range 2–94 days). Small bowel injuries were more common than colonic injuries (75.3% vs 63.8%). Multiple colon injuries, renal injuries, extra hepatic biliary injuries and older age were associated with significant increase in mortality.

Conclusion: This study’s findings underscore the multifaceted nature of bowel injury management in an ICU population. A comprehensive, multidisciplinary approach that considers injury severity, anatomical site, and patient-specific factors is crucial for  achieving favourable outcomes in bowel trauma cases.