A meta-analysis of the incidence of intra-abdominal injuries associated with thoracic or lumbar flexion-distraction injuries

IF 2.2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2025-04-08 DOI:10.1016/j.injury.2025.112337

Ibrahim Serag , Julian Scherer , Eugen Cezar Popescu , Bogdan Costachescu , Martin Holas , Abdullah salah Alahmadi , Mohamed M. Aly

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引用次数: 0

Abstract

Background

Intra-abdominal injuries (IAIs) are often associated with thoracic or lumbar flexion distraction injuries (TLFDIs) or Chance fractures. The incidence ranges from 10 to 50 % in previous literature.

Aim

To synthesize data about the incidence of IAIs associated with TLFDIs.

Methods

We searched PubMed, WOS, and Cochrane databases for all studies reporting the incidence of IAIs associated with TL FDIs. The primary outcome was the overall pooled incidence of IAIs, surgical intervention, and specific organ injuries. A subgroup analysis was done for studies that included adults, pediatrics, and mixed populations. We assessed the methodological quality of the included studies using the Newcastle-Ottawa Scale. We used A random effects model to calculate pooled incidence rates and heterogeneity. This systematic analysis followed PRISMA guidelines.

Results

A total of eight retrospective studies with 652 patients met the inclusion criteria. The pooled incidence of overall IAIs associated with TLFDIs was 36.2 % (95 % CI: 32.2 % %–57.2 %), with high heterogeneity (I² = 90.71 %, p = 0.0001). The incidence of surgical interventions was 29.03 % (95 % CI: 22.0 %–48.3 %), with high heterogeneity (I² = 92.3 %, p < 0.0001). Small bowel injuries occurred in 19.17 % of cases, large bowel injuries in 10.92 %, liver injuries in 7.6 %, splenic injuries in 7.2 %, kidney injuries in 5.36 %, and pancreatic injuries in 3.7 %. Pediatric populations showed significantly higher rates of IAAs (55.8 % vs. 23.03 %) and surgical intervention (45.5 % vs.10.6 %) than adults.

Conclusion

The pooled incidence of IAAs associated with TL FDIs is 36.2 %, and surgical intervention is 29.03 %. Small bowels, large bowels, liver, and splenic injuries were the most frequent injuries. These rates are probably overestimated due to the retrospective design of studies and the variability in the definition of TLFDIs. Therefore, prospective, well-designed studies are needed to estimate the true incidence of IAAs associated with TLFDIs accurately.

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一项与胸椎或腰椎屈曲牵张损伤相关的腹内损伤发生率的荟萃分析

背景：腹侧损伤（IAIs）常与胸椎或腰椎屈曲牵张损伤（TLFDIs）或Chance骨折相关。在以前的文献中，发病率从10%到50%不等。目的综合tlfdi相关的IAIs发生率资料。方法：我们检索PubMed、WOS和Cochrane数据库，查找所有报道与TL fdi相关的IAIs发生率的研究。主要结局是IAIs、手术干预和特异性器官损伤的总合并发生率。对包括成人、儿科和混合人群在内的研究进行了亚组分析。我们使用纽卡斯尔-渥太华量表评估纳入研究的方法学质量。我们使用随机效应模型来计算合并发病率和异质性。该系统分析遵循PRISMA指南。结果共有8项回顾性研究652例患者符合纳入标准。与tlfdi相关的总体IAIs合并发生率为36.2% (95% CI: 32.2% - 57.2%)，异质性较高（I²= 90.71%,p = 0.0001）。手术干预发生率为29.03% (95% CI: 22.0% - 48.3%)，异质性较高(I²= 92.3%,p <；0.0001)。小肠损伤占19.17%，大肠损伤占10.92%，肝脏损伤占7.6%，脾脏损伤占7.2%，肾脏损伤占5.36%，胰腺损伤占3.7%。儿童的IAAs发生率（55.8% vs. 23.03%）和手术干预率（45.5% vs. 10.6%）明显高于成人。结论IAAs合并tlfdi的总发生率为36.2%，手术干预发生率为29.03%。小肠、大肠、肝脏和脾脏损伤是最常见的损伤。由于研究的回顾性设计和tlfdi定义的可变性，这些比率可能被高估了。因此，需要前瞻性的、设计良好的研究来准确估计与tlfdi相关的IAAs的真实发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.