Abdominal gunshot wounds - A comparative assessment of severity measures

Adil Aijaz Shah, Abdul Rehman, Syed Jawad Shah, Adil H. Haider, Cheryl K. Zogg, Syed Nabeel Zafar, Yousaf Bashir Hadi, [No Value] Zia-Ur-Rehman, Hasnain Zafar

Research output: Contribution to journalArticle

Abstract

Background Penetrating abdominal trauma is a common feature of trauma treated in low- and middle-income countries (LMICs). The penetrating abdominal trauma index (PATI) and the injury severity score (ISS) are severity-measures most often used to gauge injury severity. It remains unclear which measure better accounts for the severity of sustained injuries. This study compares the predictive ability of both injury severity measures in patients presenting to an LMIC in South Asia. Methods All isolated gunshot wounds to the abdomen presenting to a university hospital between 2011 and 2012 were included. ISS and PATI were calculated for each case. Primary outcome measures included all-cause mortality and complications. Multivariable analysis adjusting for age, sex, referral status, hypotension, tachycardia, and injury severity measures was performed. The area under the receiver operating characteristic (AUROC) curve were further calculated to compare the respective abilities of ISS and PATI at predicting death and complications. Results A total of 70 patients were included. The average age on presentation was 34.5 y (±11.4) within a predominantly male (n = 68, 97.1%) cohort. Most gunshot wounds were intentionally inflicted (n = 67, 95.7%). The crude rates of death and complications were 34.3% and 15.7%, respectively. The median ISS was 14 (interquartile range: 11-21), and the median PATI was 16 (interquartile range: 9-26). AUROC analysis revealed that ISS was comparable with PATI at predicting mortality (AUROC [95% confidence interval]: 0.952 [0.902-1.00] versus 0.934 [0.860-1.00]) and complications (AUROC [95% confidence interval]: 0.868 [0.778-0.959] versus 0.895 [0.815-0.975]). Conclusions The predictive ability of ISS and PATI severity measures was found to be comparable. The results suggest that both measures can be used to risk-stratify patients with isolated abdominal gunshot wounds in an LMIC.

Original languageEnglish (US)
Pages (from-to)334-339
Number of pages6
JournalJournal of Surgical Research
Volume198
Issue number2
DOIs
StatePublished - Oct 1 2015
Externally publishedYes

Fingerprint

Gunshot Wounds
Injury Severity Score
Wounds and Injuries
ROC Curve
Trauma Severity Indices
Mortality
Confidence Intervals
Tachycardia
Abdomen
Hypotension
Referral and Consultation
Outcome Assessment (Health Care)

Keywords

  • Area under receiver operating characteristic
  • Injury severity score
  • Low-middle income country
  • Penetrating abdominal trauma
  • Penetrating abdominal trauma index
  • Prognosis

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Shah, A. A., Rehman, A., Shah, S. J., Haider, A. H., Zogg, C. K., Zafar, S. N., ... Zafar, H. (2015). Abdominal gunshot wounds - A comparative assessment of severity measures. Journal of Surgical Research, 198(2), 334-339. https://doi.org/10.1016/j.jss.2015.03.061

Abdominal gunshot wounds - A comparative assessment of severity measures. / Shah, Adil Aijaz; Rehman, Abdul; Shah, Syed Jawad; Haider, Adil H.; Zogg, Cheryl K.; Zafar, Syed Nabeel; Hadi, Yousaf Bashir; Zia-Ur-Rehman, [No Value]; Zafar, Hasnain.

In: Journal of Surgical Research, Vol. 198, No. 2, 01.10.2015, p. 334-339.

Research output: Contribution to journalArticle

Shah, AA, Rehman, A, Shah, SJ, Haider, AH, Zogg, CK, Zafar, SN, Hadi, YB, Zia-Ur-Rehman, NV & Zafar, H 2015, 'Abdominal gunshot wounds - A comparative assessment of severity measures', Journal of Surgical Research, vol. 198, no. 2, pp. 334-339. https://doi.org/10.1016/j.jss.2015.03.061
Shah AA, Rehman A, Shah SJ, Haider AH, Zogg CK, Zafar SN et al. Abdominal gunshot wounds - A comparative assessment of severity measures. Journal of Surgical Research. 2015 Oct 1;198(2):334-339. https://doi.org/10.1016/j.jss.2015.03.061
Shah, Adil Aijaz ; Rehman, Abdul ; Shah, Syed Jawad ; Haider, Adil H. ; Zogg, Cheryl K. ; Zafar, Syed Nabeel ; Hadi, Yousaf Bashir ; Zia-Ur-Rehman, [No Value] ; Zafar, Hasnain. / Abdominal gunshot wounds - A comparative assessment of severity measures. In: Journal of Surgical Research. 2015 ; Vol. 198, No. 2. pp. 334-339.
@article{8ab8c8bd8953442a956984a54af2f60f,
title = "Abdominal gunshot wounds - A comparative assessment of severity measures",
abstract = "Background Penetrating abdominal trauma is a common feature of trauma treated in low- and middle-income countries (LMICs). The penetrating abdominal trauma index (PATI) and the injury severity score (ISS) are severity-measures most often used to gauge injury severity. It remains unclear which measure better accounts for the severity of sustained injuries. This study compares the predictive ability of both injury severity measures in patients presenting to an LMIC in South Asia. Methods All isolated gunshot wounds to the abdomen presenting to a university hospital between 2011 and 2012 were included. ISS and PATI were calculated for each case. Primary outcome measures included all-cause mortality and complications. Multivariable analysis adjusting for age, sex, referral status, hypotension, tachycardia, and injury severity measures was performed. The area under the receiver operating characteristic (AUROC) curve were further calculated to compare the respective abilities of ISS and PATI at predicting death and complications. Results A total of 70 patients were included. The average age on presentation was 34.5 y (±11.4) within a predominantly male (n = 68, 97.1{\%}) cohort. Most gunshot wounds were intentionally inflicted (n = 67, 95.7{\%}). The crude rates of death and complications were 34.3{\%} and 15.7{\%}, respectively. The median ISS was 14 (interquartile range: 11-21), and the median PATI was 16 (interquartile range: 9-26). AUROC analysis revealed that ISS was comparable with PATI at predicting mortality (AUROC [95{\%} confidence interval]: 0.952 [0.902-1.00] versus 0.934 [0.860-1.00]) and complications (AUROC [95{\%} confidence interval]: 0.868 [0.778-0.959] versus 0.895 [0.815-0.975]). Conclusions The predictive ability of ISS and PATI severity measures was found to be comparable. The results suggest that both measures can be used to risk-stratify patients with isolated abdominal gunshot wounds in an LMIC.",
keywords = "Area under receiver operating characteristic, Injury severity score, Low-middle income country, Penetrating abdominal trauma, Penetrating abdominal trauma index, Prognosis",
author = "Shah, {Adil Aijaz} and Abdul Rehman and Shah, {Syed Jawad} and Haider, {Adil H.} and Zogg, {Cheryl K.} and Zafar, {Syed Nabeel} and Hadi, {Yousaf Bashir} and Zia-Ur-Rehman, {[No Value]} and Hasnain Zafar",
year = "2015",
month = "10",
day = "1",
doi = "10.1016/j.jss.2015.03.061",
language = "English (US)",
volume = "198",
pages = "334--339",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Abdominal gunshot wounds - A comparative assessment of severity measures

AU - Shah, Adil Aijaz

AU - Rehman, Abdul

AU - Shah, Syed Jawad

AU - Haider, Adil H.

AU - Zogg, Cheryl K.

AU - Zafar, Syed Nabeel

AU - Hadi, Yousaf Bashir

AU - Zia-Ur-Rehman, [No Value]

AU - Zafar, Hasnain

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Background Penetrating abdominal trauma is a common feature of trauma treated in low- and middle-income countries (LMICs). The penetrating abdominal trauma index (PATI) and the injury severity score (ISS) are severity-measures most often used to gauge injury severity. It remains unclear which measure better accounts for the severity of sustained injuries. This study compares the predictive ability of both injury severity measures in patients presenting to an LMIC in South Asia. Methods All isolated gunshot wounds to the abdomen presenting to a university hospital between 2011 and 2012 were included. ISS and PATI were calculated for each case. Primary outcome measures included all-cause mortality and complications. Multivariable analysis adjusting for age, sex, referral status, hypotension, tachycardia, and injury severity measures was performed. The area under the receiver operating characteristic (AUROC) curve were further calculated to compare the respective abilities of ISS and PATI at predicting death and complications. Results A total of 70 patients were included. The average age on presentation was 34.5 y (±11.4) within a predominantly male (n = 68, 97.1%) cohort. Most gunshot wounds were intentionally inflicted (n = 67, 95.7%). The crude rates of death and complications were 34.3% and 15.7%, respectively. The median ISS was 14 (interquartile range: 11-21), and the median PATI was 16 (interquartile range: 9-26). AUROC analysis revealed that ISS was comparable with PATI at predicting mortality (AUROC [95% confidence interval]: 0.952 [0.902-1.00] versus 0.934 [0.860-1.00]) and complications (AUROC [95% confidence interval]: 0.868 [0.778-0.959] versus 0.895 [0.815-0.975]). Conclusions The predictive ability of ISS and PATI severity measures was found to be comparable. The results suggest that both measures can be used to risk-stratify patients with isolated abdominal gunshot wounds in an LMIC.

AB - Background Penetrating abdominal trauma is a common feature of trauma treated in low- and middle-income countries (LMICs). The penetrating abdominal trauma index (PATI) and the injury severity score (ISS) are severity-measures most often used to gauge injury severity. It remains unclear which measure better accounts for the severity of sustained injuries. This study compares the predictive ability of both injury severity measures in patients presenting to an LMIC in South Asia. Methods All isolated gunshot wounds to the abdomen presenting to a university hospital between 2011 and 2012 were included. ISS and PATI were calculated for each case. Primary outcome measures included all-cause mortality and complications. Multivariable analysis adjusting for age, sex, referral status, hypotension, tachycardia, and injury severity measures was performed. The area under the receiver operating characteristic (AUROC) curve were further calculated to compare the respective abilities of ISS and PATI at predicting death and complications. Results A total of 70 patients were included. The average age on presentation was 34.5 y (±11.4) within a predominantly male (n = 68, 97.1%) cohort. Most gunshot wounds were intentionally inflicted (n = 67, 95.7%). The crude rates of death and complications were 34.3% and 15.7%, respectively. The median ISS was 14 (interquartile range: 11-21), and the median PATI was 16 (interquartile range: 9-26). AUROC analysis revealed that ISS was comparable with PATI at predicting mortality (AUROC [95% confidence interval]: 0.952 [0.902-1.00] versus 0.934 [0.860-1.00]) and complications (AUROC [95% confidence interval]: 0.868 [0.778-0.959] versus 0.895 [0.815-0.975]). Conclusions The predictive ability of ISS and PATI severity measures was found to be comparable. The results suggest that both measures can be used to risk-stratify patients with isolated abdominal gunshot wounds in an LMIC.

KW - Area under receiver operating characteristic

KW - Injury severity score

KW - Low-middle income country

KW - Penetrating abdominal trauma

KW - Penetrating abdominal trauma index

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=84940722907&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940722907&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2015.03.061

DO - 10.1016/j.jss.2015.03.061

M3 - Article

C2 - 25891680

AN - SCOPUS:84940722907

VL - 198

SP - 334

EP - 339

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 2

ER -