Incidence and Predictors of Hollow Viscus Injury in Patients With Abdominal Morel-Lavalleé Injury

Introduction

Abdominal Morel-Lavalleé (ML) injuries, though rare, are associated with serious clinical implications, such as concomitant hollow viscus injury (HVI). However, research on the incidence of HVI in patients with abdominal ML injuries remains lacking. This study aimed to identify the incidence and predictors of HVI in patients with abdominal ML injury.

Methods

The 2017-2021 Trauma Quality Improvement Program database was queried for patients with abdominal ML injuries, ages 18 and older. Patients with abdominal ML + HVI were compared to patients with abdominal ML without HVI. A multivariable logistic regression analysis was performed to identify associated risk factors for HVI.

Results

Of 1439 patients with abdominal ML injuries, 532 (37.0%) suffered HVI. Compared to non-HVI patients, those with HVI were more often 30 years old or younger (44.0% vs 23.9%; P < 0.001) and had higher rates of motor vehicle collision (MVC) (84.2% vs 40.1%; P < 0.001). Abdominal ML + HVI patients had increased rates of spleen injuries (21.1% vs 6.1%; P < 0.001) and liver injuries (17.3% vs 7.4%, P < 0.001). The strongest independent associated risk factors for HVI in patients with abdominal ML injuries were age less than 30 years old (odds ratio [OR]: 1.94; confidence interval [CI]: 1.46-2.57; P < 0.001), MVC mechanism (OR: 7.89; CI: 5.77-10.80; P < 0.001), spleen injury (OR: 2.82; CI: 1.87-4.27; P < 0.001), and liver injury (OR: 1.80; CI: 1.19-2.73; P = 0.01).

Conclusions

This national analysis demonstrates that 40% of patients with abdominal ML injury suffered HVI. Associated risk factors for HVI with abdominal ML injury included younger age, injuries to the spleen and liver, and an MVC mechanism of injury. These findings can help inform clinical decisions and improve prognostication for patients with abdominal ML injury.