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Factors affecting outcome in penetrating oesophageal trauma

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Background:

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.

Methods:

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.

Results:

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).

Conclusion:

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.
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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

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