Independent risk factors of morbidity in penetrating colon injuries

BACKGROUND The present study explored the factors effective on colon-related morbidity in patients with penetrating injury of the colon. METHODS The medical records of 196 patients were reviewed for variables including age, gender, factor of trauma, time between injury and operation, shock, duration of operation, Penetrating Abdominal Trauma Index (PATI), Injury Severity Score (ISS), site of colon injury, Colon Injury Score, fecal contamination, number of associated intra- and extraabdominal organ injuries, units of transfused blood within the first 24 hours, and type of surgery. In order to determine the independent risk factors, multivariate logistic regression analysis was performed. RESULTS Gunshot wounds, interval between injury and operation >= 6 hours, shock, duration of the operation >= 6 hours, PATI >= 25, ISS >= 20, Colon Injury Score >= grade 3, major fecal contamination, number of associated intraabdominal organ injuries >2, number of associated extraabdominal organ injuries >2, multiple blood transfusions, and diversion were significantly associated with morbidity. Multivariate logistic regression analysis showed diversion and transfusion of >= 4 units in the first 24 hours as independent risk factors affecting colon-related morbidity. CONCLUSION Diversion and transfusion of >= 4 units in the first 24 hours were determined to be independent risk factors for colon-related morbidity.