Does the problem of foreign language and substance / alcohol usage increase the rate of non-therapeutic laparotomy in penetrating abdominal stab injuries?

Abstract

INTRODUCTION: We aimed to evaluate effect of foreign language problem and substance/alcohol usage on rate of non-therapeutic laparotomy in penetrating abdominal stab injuries (PASI). METHODS: Data of 89 patients with PASI treated between January 2015 and December 2017 were evaluated retrospectively. Age, gender, injury site, surgery requirement, surgery type, patients' language problems (not knowing Turkish and English) and substance/alcohol usage were recorded. Patients were divided into two groups according to language problem: 51 patients without problem were defined as Group 1, and 38 patients with problem were Group 2; also divided into two groups according to substance/alcohol usage: nonuser 69 patients were Group 3, user 20 patients were Group 4. RESULTS: Female/male ratio was 5/84 and mean age was 28.5+-8.9. Most common injury site was epigastric region (27%), and most frequently injured organ with lumen was small intestine (40.7%). Rate of surgery (52.6% and 80%) and of non-therapeutic laparotomy (18.4% and 30%) in group 2 and 4 were higher than group 1 and 3 (p<0.05 and p<0.01). Frequency of blood transfusion (28.9% and 35%) and amount of erythrocyte suspension (1.2+-2.2 and 1.3+-2.3) in group 2 and 4 was higher than others (p<0.05). Ratio of hematocrit in patients undergone therapeutic laparotomy (n=27) was lower (p<0.05), and neutrophil and platelet counts were higher compared to non-therapeutic group (p<0.05). DISCUSSION AND CONCLUSION: We concluded that surgical decision in PASI was affected by insufficient anamnesis and examination due to language problem or substance/alcohol usage, resulting in unnecessary laparotomy and increase rates of non-therapeutic laparotomies.

Keywords

• abdominal trauma
• laparotomy
• foreign language
• substance/alcohol usage