Outcome of gunshot abdominal injuries
Aim: To describe prevalence, management and factors determining outcomes in patients presenting with gunshot abdominal injuries.
Method: We retrospectively analysed all cases of gunshot to the abdomen received at Kenyatta National Hospital from October 2013 to October 2017. Patients’ demographic and clinical data were collected from their case notes. Data analysis used Fisher’s exact test and binary logistic regression. A p-value of <0.05 was considered statistically significant.
Results: A total of 1,588 records of patients with abdominal injuries were analysed. Of these, 209(15.3%) were cases of gunshot to the abdomen. The mean age was 31.5 years; male to female ratio was 8:1. Exploratory laparotomy was the preferred management in 161(77%) patients, selective nonoperative management in 11(5.3). Negative laparotomy rate was 8.7%, inpatient mortality 20% and complication rate 26%. Age, time from injury to admission, assisted breathing on admission, need for transfusion, and number of complications independently predicted mortality.
Conclusion: Gunshot abdominal injuries are commonly encountered at our setting and these are associated with significant mortality and development of complications. With careful selection, some patients can be successfully managed non-operatively.
Keywords: Gunshot, Abdomen, Mortality, Outcome