A prospective study on abdominal trauma: patterns of injury, clinical presentation, organ involvement, associated injuries, and outcomes at a tertiary hospital in Mogadishu, Somalia.

内容摘要

Trauma is a major global public health problem and one of the leading causes of death and disability worldwide, particularly among individuals younger than 44 years of age. Approximately 6 million people die each year as a result of traumatic injuries, with nearly 90% of these deaths occurring in low- and middle-income countries. Previous epidemiological studies have reported postoperative complication rates ranging from 18% to 42% and mortality rates between 8.5% and 13%. To evaluate the patterns of injury, clinical presentation, organ involvement, associated injuries, management strategies, and outcomes among adult patients with abdominal trauma in Mogadishu, Somalia. A prospective observational study was conducted from August 2023 to July 2024 at Mogadishu Somali-Türkiye Recep Tayyip Erdoğan Training and Research Hospital. A total of 146 adult patients with abdominal trauma were enrolled. Data were collected using a pretested structured questionnaire and analyzed using Stata version 16. Univariable and multivariable logistic regression analyses were performed to identify factors independently associated with in-hospital mortality. The study population consisted predominantly of young adult males, with a mean age of 30.18 ± 9.2 years, and males accounted for 97.3% of all patients. Penetrating trauma was the predominant mechanism of injury (95.9%), with gunshot wounds representing the most common cause (71.9%). The small intestine and colon were the most frequently injured organs, each accounting for 40.4% of cases, and multiple organ injuries were identified in 56.8% of patients. Surgical intervention was performed in 88.4% of patients, while the overall in-hospital mortality rate was 16.4%. Multivariable logistic regression identified intensive care unit (ICU) admission (adjusted odds ratio [AOR] = 12.85; 95% confidence interval [CI]: 2.34-70.59) and delayed surgical intervention (≥ 6 h) (AOR = 107.9; 95% CI: 12.9-903.5) as independent predictors of mortality. Penetrating abdominal trauma, predominantly caused by gunshot wounds, represents the leading mechanism of injury in Mogadishu and primarily affects young adult males. Injuries to the small intestine and colon were the most common, and multiple organ involvement was frequently encountered. Most patients required operative management, and prompt surgical intervention was associated with improved survival. ICU admission and delayed surgical intervention were independent predictors of in-hospital mortality. These findings underscore the urgent need to strengthen trauma care infrastructure, optimize emergency surgical services, and implement preventive strategies tailored to Somalia's high-risk environment.