The Presence of Hemorrhagic Shock on Admission Is the Strongest Predictor of Mortality in Trauma Patients Who Require Packing

The aim of this study was to evaluate patients who had to be applied with packing because of abdominal trauma and to identify the factors affecting mortality from the findings on admission and the laboratory values that can be immediately examined. A retrospective analysis of 42 patients accepted to our level one trauma center between January 1998 and December 2017 was carried out. The patients were evaluated in respect of demographic characteristics, vital parameters, trauma type, injury severity score (ISS), the presence of additional injuries, transfusion amount, the need for intensive care, mortality rates, complications, the number and types of operations performed, the number of packings, the need for re-laparotomy, imaging methods, and radiological interventions. Of these parameters, the effects on mortality of findings on admission and the laboratory values that could be immediately tested were examined in particular. Packing was applied to 27 patients due to blunt trauma and to 15 patients due to penetrating trauma. Thirty-one patients had hypotension, and 24 of them had hemorrhagic shock status upon admission. Average ISS value was 34.5 +/- 9.9 (16-59). Twenty of the 42 patients died (47.6%). ISS level, hypotension, and hemorrhagic shock on admission were found to be significant risk factors of death in univariate analysis. In multivariate analysis however, only the presence of hemorrhagic shock was a statistically significant factor related to mortality. The presence of hemorrhagic shock on admission is a strong predictor of mortality in patients undergoing damage control surgery.