2020 Volume 34 Issue 1 Pages 1-5
Background : In elderly patients with an isolated abdominal injury, despite stable vital signs, some patients experience a minor disturbance of consciousness (DOC) due to delirium and a transient, relatively-decreased cerebral blood flow. Our study aimed to elucidate the association between the occurrence of minor DOC and in-hospital mortality. Methods : Using data from the Japan Trauma Data Bank, patients (> 65 years) registered as having isolated abdominal injuries between 2004 and 2017 were enrolled in the study. Exclusion criteria were as follows : 1) penetrating injuries, 2) systemic blood pressure < 90 mmHg on arrival, 3) JCS > 2, 4) alcohol consumption, 5) history of psychological illness or dementia, and 6) injury severity score (ISS) < 9. In-hospital mortality as a primary outcome was compared between the groups with and without minor DOC. Results : Among 54 cases of minor DOC and 212 cases of awake and alert (JCS 0), we recorded 12 and 14 in-hospital mortality cases, respectively. Multivariate analysis, performed using in-hospital mortality as the outcome, showed that minor DOC cases had an odds ratio of 3.26. Conclusion : In elderly patients with isolated abdominal injuries, minor DOC upon arrival is associated with in-hospital mortality.
