Predictive factors of mortality in patients with abdominal trauma.

Abstract

Background: Traumatic injuries, particularly abdominal trauma, are a major cause of mortality worldwide. This study aimed to evaluate predictive factors for mortality and morbidity in abdominal trauma patients using simple, rapid, and accessible clinical and laboratory parameters, with a focus on developing scoring systems for emergency department decision-making.

Methods: A retrospective cohort study was conducted in a Level 1 Trauma Center between October 2022 and March 2024. Patients aged 18 and older with abdominal trauma or multi-trauma were included, while cases with incomplete records, known chronic diseases, or a recent trauma history were excluded. Data on demographics, vital signs, laboratory results, imaging findings, clinical scores, and outcomes were collected. Logistic regression and receiver operating characteristic (ROC) analyses were performed to identify independent mortality predictors and their cut-off values.

Results: Out of 693 patients, the mortality rate was 3.6%. The most common mechanisms of trauma were road traffic accidents (59.3%) and falls (23.4%). Independent predictors of mortality included age ≥54 years, Glasgow Coma Scale (GCS) ≤14, Injury Severity Score (ISS) ≥24, and Shock Index ≥1.08. ROC analysis revealed that GCS had the highest predictive value for mortality (area under the curve [AUC]: 0.828), followed by ISS, age, and Shock Index. Elevated levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate, and creatinine were associated with worse outcomes, aligning with findings in the literature.

Conclusion: Age, GCS, ISS, and Shock Index are strong predictors of mortality in abdominal trauma patients. Integrating these parameters into clinical decision-making can enhance risk stratification and improve patient management. Prospective multicenter studies and national trauma registries are necessary to refine trauma care and reduce mortality rates.