Abstract

This was a retrospective study of patients presenting to 12 Level 1 trauma centers between 2016 and 2020 with penetrating colon injuries and AIS < 3 in other body regions. We assessed the association of the new OIS with surgical management and clinical outcomes and the association of OIS imaging criteria with operative criteria. Bivariate analysis was done with chi-square, ANOVA, and Kruskal Wallis, where appropriate. Multivariable models were constructed in a stepwise selection fashion.We identified 573 patients with penetrating colon injuries. Patients were young and predominantly male; 79% suffered a gunshot injury, 11% had a grade-V destructive injury, 19% required =6 units of transfusion, 24% had an ISS > 15, and 42% had moderate-to-large contamination. Higher OIS was independently associated with a lower likelihood of primary repair, higher likelihood of resection with anastomosis and/or diversion, need for damage control laparotomy, and higher incidence of abscess, wound infection, extra-abdominal infections, acute kidney injury, and lung injury. Damage control was independently associated with diversion and intra- and extra-abdominal infections. Pre-operative imaging in 152 (27%) cases had a low correlation with operative findings (Kappa coefficient 0.13).This is the largest study to date of penetrating colon injuries and the first multicenter validation of the new OIS specific to these injuries. While imaging criteria alone lacked strong predictive value, operative AAST OIS colon grade strongly predicted type of interventions and outcomes, supporting use of this grading scale for research and clinical practice.III.

View details for DOI 10.1097/TA.0000000000003969

View details for PubMedID 37072893