Declining Hemoglobin Count Related Factors in Abdominal Blunt Trauma Patients

Undergoing Laparotomy Surgery.

Abdominal trauma ranks third as cause of death in trauma related patient after head injury and
thoracic injury. Mostly patient with hepatic blunt trauma that admitted to hospital already in
hypovolemic state because of massive ongoing bleeding in abdominal cavity. Liver is a solid
organ in abdominal cavity with highest incidency rate related with abdominal blunt trauma. At least
15-20% of abdominal blunt trauma is related to hepatic injury. 80-90% hepatic injury is related to
abdominal blunt trauma. Major injury including surgery usually followed with systemic
inflammation response that contributing fluid shifting into interstitial and intravascular. This
response usually followed by declining hemoglobin count in patient.
This research was done using retroelective pre-post test design based on patient medical
record from Sanglah central hospital in Bali. The research was conducted from January 2017 until
December 2017 with total 60 patient as sample. This research evaluate declining hemoglobin
count in traumatic liver injury patient related to abdominal blunt trauma that undergoing
laparotomy surgery based on patient nutritional status, surgery duration, total bleeding, and
clotting factor.
Characteristic distributed by sex was 70% male and 30% female. Characteristic by past
hepatic illness was 3.3% with liver related comorbidities, and 96.7% without liver related
comorbidities. Characteristic by past heart illness was 1.7% with heart related comorbidities and
98.3% without heart related comorbidities. Characteristic by diabetic comorbidities was 3.3% with
diabetes and 96.7% without diabetes. The result was patients nutritional status and surgery
duration contributed with declining hemoglobin count in patient after surgery (respectively p-value
0.006 and 0.0039), total bleeding and clotting factor did not contributed with declining hemoglobin
count in patient after surgery (respectively p-value 0.277 and 0.165).
Surgical intervention could possibly lead to declining hemoglobin count in patient with
hepatic blunt trauma. It is important to evaluate patient before undergoing surgery particularly
preparing blood transfusion. Short surgery duration could reducing ongoing bleeding process.
Keywords : hepatic blunt trauma, laparotomy, hemoglobin