caa a22 4500 606247688 CHVBK 20210128101346.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s12262-013-0970-9 doi (NATIONALLICENCE)springer-10.1007/s12262-013-0970-9 Traumatic Diaphragmatic Injury: A Marker of Serious Injury Challenging Trauma Surgeons [Elektronische Daten] [Subodh Kumar, Manjunath Pol, Biplab Mishra, Sushma Sagar, Manish Singhal, Mahesh Misra, Amit Gupta] The objectives of this study are (1) to evaluate prevalence of traumatic diaphragmatic injury (TDI), (2) identify the predictors of mortality, and (3) study the accuracy of investigations in survivors of TDI. Retrospective analysis of prospectively maintained database of TDI from January 2007 to December 2011. Emergency department (ED) records, operative details, and autopsy reports were reviewed to determine injury characteristics, treatment provided, and outcome. Statistical analyses were performed using the SPSS ver.15 software. TDI was identified in 75 individuals. Thirty-two of 75 (42.6%) cases were brought dead to the hospital, and 43/75 (57.3%) were survivors presented to emergency department, diagnosed to have TDI intraoperatively. Seven of 43 (16.3%) died postoperatively. Mortality in TDI was significantly related to age (p = 0.001), injury severity (p < 0.001), site of TDI (p = 0.002), and associated injuries (p = 0.021, odds ratio of 9). Death increased with increase in the number of organ injured (p < 0.001, odds ratio of 12). Multi-detector computer tomography (MDCT) detected TDI in 23/26 (88.5%) cases preoperatively. Laparotomy (p < 0.001, odds ratio of 22) and thoracotomy (p = 0.021, with odds ratio of 9) were associated with survival benefit when compared to minimal invasive surgery in injured cases. The prevalence of TDI was 2.67%, TDI's mark severity of injury. Mortality increases with increasing number of organ injured. Right-sided or bilateral injury of diaphragm is associated with increased mortality. Association of Surgeons of India, 2013 Trauma nationallicence Diaphragmatic injury nationallicence Associated injury nationallicence Diagnostic challenge nationallicence Severity of injury nationallicence Laparotomy nationallicence Kumar Subodh Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut Pol Manjunath Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut Mishra Biplab Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut Sagar Sushma Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut Singhal Manish Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut Misra Mahesh Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut Gupta Amit Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut Indian Journal of Surgery Springer India 77(2015-12-01), 666-669 0972-2068 77<666 2015 77 12262 https://doi.org/10.1007/s12262-013-0970-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-013-0970-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kumar Subodh Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 700 1- Pol Manjunath Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 700 1- Mishra Biplab Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 700 1- Sagar Sushma Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 700 1- Singhal Manish Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 700 1- Misra Mahesh Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 700 1- Gupta Amit Department of Surgical Disciplines, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77(2015-12-01), 666-669 0972-2068 77<666 2015 77 12262