Abstract

Introduction: Blunt abdominal trauma (BAT) remains a significant cause of trauma-related morbidity and mortality, with complex diagnostic and therapeutic challenges worldwide. Intra-abdominal injuries often present with vague or delayed presentation, which necessitates an increased index of suspicion, systematic evaluation, and individualized treatment strategies. Prognostic factors are crucial in determining patient outcomes and clinical decision-making.

This study aimed to identify the prognostic determinants of outcomes in patients with BAT.

Materials and Methods: Over the period from December 2021 to December 2023, 240 patients who experienced arrival at the University Hospital of Trauma (UHT), Tirana, Albania, were prospectively analyzed. The parameters considered were hemodynamic stability at admission, Injury Severity Score (ISS), severity and nature of specific organ injuries, patient's age, comorbidities, time for definitive treatment, and presence of associated extra-abdominal injuries. Standardized diagnostic protocols used were primary and secondary surveys, targeted imaging (FAST, CT), lab workup, and serial clinical exams. Statistical analysis was performed using Kendall's tau correlation coefficient, a commonly used measure of correlation between two variables, with a significance level of p < 0.05.

Results: Our study findings emphasize the critical role of hemodynamic stability at presentation, elevated ISS, advanced age, late hospital arrival, and concomitant significant injury in predicting unfavorable outcomes for BAT patients. Conversely, early diagnosis, proper operative or nonoperative treatment based on injury severity, and intensive care monitoring during close follow-up enhanced survival. Organ-oriented injury patterns—particularly severe splenic and hepatic injuries—were independent predictors of morbidity and were highly valuable for clinical practice.

Conclusion: BAT outcome optimization requires early identification of prognostic factors, rapid stabilization, and individually adapted treatment plans supported by multidisciplinary expertise. These results support the importance of continuous team training, efficient organization of a trauma system, and protocol-based care to maximize patient survival and recovery. The importance of continuous professional development cannot be overstated in trauma care management.

Keywords: Blunt Abdominal Trauma, Prognostic Factors, Hemodynamic Stability, Injury Severity Score, Trauma Management