Assessing the outcomes and complications of abdominal trauma using the adapted Clavien-Dindo in trauma scoring system in a tertiary hospital: an observational study.

Abstract

Purpose: The adapted Clavien-Dindo in trauma (ACDiT) scoring system modifies the original Clavien-Dindo system to grade complications in both operatively and nonoperatively managed trauma patients. This study aimed to validate the ACDiT tool as a novel outcome measure in abdominal trauma patients, correlating ACDiT scores with hospital length of stay (LOS), intensive care unit (ICU) LOS, and mortality. We also described injury patterns and identified factors associated with morbidity and mortality.

Methods: A prospective observational study was conducted over 18 months at a tertiary hospital in Western Rajasthan, India. A total of 154 patients with an Abbreviated Injury Scale (AIS) ≥2 were included, while pregnant and lactating mothers were excluded. Complications were graded using ACDiT, and outcomes such as LOS and ICU LOS were analyzed.

Results: Among 154 patients, 90.3% sustained blunt trauma and 9.7% had penetrating injuries. Significant extra-abdominal injuries (AIS >2) were noted in 46.1%. Complications occurred in 38.3% of patients, with grade II complications being the most common (20.3%). Higher ACDiT grades were significantly associated with prolonged LOS (P<0.001) and ICU LOS (P=0.001). The ACDiT scale demonstrated a strong predictive value for morbidity and mortality (adjusted R2=0.11, P<0.001).

Conclusions: The ACDiT is a reliable and objective tool for assessing complications and outcomes in abdominal trauma patients, effectively correlating with LOS and ICU LOS.