Prognostic factors of assault-induced stab wounds in the emergency department

Safia OTHMANI, Sarra JOUINI, Asma MELLOULI, Houyem ZOUARI, Mouna JEMAI, Hana HEDHLI

Résumé

Background: Stab wounds (SWs) represent one of the major components of trauma, especially in the emergency department (ED), and can have dreadful outcomes.
Aim: Our study aimed to assess the different epidemiological, clinical, and therapeutic features of SWs in the ED as well as prognostic factors determining short-term evolution (STE).
Method: A descriptive, cross-sectional single-center study was conducted in a polyvalent ED room of the Charles Nicolle hospital of Tunis, including patients presenting for assault-induced over ten months.
Unfavorable STE was defined by: oxygen therapy needs, fluid expansion, catecholamine and/or tranexamic acid use, transfusion, thoracic drainage, intubation, and urgent surgery.
The statistical analysis concerned the study population (SP) subgroups who have penetrating stab wounds (PSWs) or superficial stab wounds (SSWs). The risk factors search of STE was carried out by a univariate analysis, binary logistic regression with Receiver Operating Characteristics curves (ROC) analysis.
Results: We included 130 patients, with male predominance and a sex ratio of 15. The median age was 30. The majority (90.8%) had no pathological medical history. Forty percent of the injuries were located on the torso (n=52). Initial clinical assessment showed that most of the patients were hemodynamically stable Four patients (3.1%) had systolic blood pr tients (6.2%) a mean arterial blood pressure (MAP) <65mmHg. Seven patients (5.4%) were hypoxemic. Univariate analysis showed that respiratory rate (RR), and blood pressure (BP) were significantly associated with unfavorable STE. Receiving operating curve (ROC) analysis concluded a high discriminating ability for RR and BP. Logistic regression analysis showed that RR>19cpm and SBP <105 mmHg are  independent risk factors with respective AORs of 8.64 and 14.29 IC.
Conclusion: Unfavorable STE can be predicted through clinical parameters such as RR>19cpm and/or SBP<105 mmHg in PSW's victims.