Mortality in Retroperitoneal Hematoma

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Abstract
Patients (81) sustained retroperitoneal hematoma (RH) from blunt (70%) and penetrating (30%) trauma. Retroperitoneal hematomas were classified into 10 centro-medial Zone I, 25 lateral Zone II and 46 pelvic Zone III hematomas. The mean Injury Severity Score (ISS) for the entire series was 26.4 .+-. 14. The mean ISS of nonsurvivors was 37.6 .+-. 12. Overall mortality was 20%; if head injury deaths are excluded (6), mortality was 13%. Retroperitoneal hematoma associated with pelvic fracture had a mortality of 19%. Incidence of respiratory failure for entire series, excluding head trauma, was 29%. Respiratory failure occurred in 37% of patients with Zone III injuries. A requirement for ventilatory support greater than 48 h was associated with a mortality of 35%. PaO2 [arterial O2 tension]/FIO2[fractional inspiratory O2] at 48 h in intubated patients was significantly decreased in nonsurvivors compared to survivors, whereas the mean ISS of this subset of patients did not differentiate between survivors and nonsurvivors.