Factors affecting outcome in penetrating oesophageal trauma
Penetrating oesophageal trauma is rare and the risk factors affecting outcome have not been clearly identified. Delayed management has been cited as a factor contributing to the high rates of morbidity and mortality, but evidence for this is lacking.
A retrospective study was undertaken of patients with penetrating oesophageal trauma presenting to a level I trauma centre over 8 years. Outcome was assessed in terms of mortality, morbidity (oesophageal and non‐oesophageal), and length of hospital and intensive care unit (ICU) stays.
Fifty‐two patients with oesophageal injury who reached the operating theatre were included. The overall mortality rate was 6 per cent. Fifteen patients (29 per cent) developed oesophageal injury‐related complications. Time from injury to management was the only important risk factor for the development of oesophageal complications (P = 0·001), but did not affect the length of ICU (P = 0·560) or hospital (P = 0·329) stay, incidence of non‐oesophageal injury‐related complications (P = 0·963) or death (P = 0·937). Patients with gunshot injuries spent longer in the ICU (P = 0·007) and the duration of hospital stay was longer for those with higher‐grade oesophageal injuries (P = 0·025).
The risk of oesophageal injury‐related complications was directly related to the interval between the trauma and definitive management of the oesophageal injury. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Document Type: Research Article
Affiliations: 1: Department of Surgery, Trauma Unit, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa 2: Department of Cardiothoracics, Trauma Unit, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
Publication date: November 1, 2004