Abdominal trauma: The penetrating abdominal trauma index (PATI)

• A method of quantifying the risk of complication following penetrating abdominal

trauma is described
• The penetrating trauma index is calculated by assigning a risk factor (1-5) to each organ
injured and then multiplying this by a severity of injury estimate (1-5)
• The sum of the individual organ scores comprised the final PATI. The range is 0-200
• The risk of postoperative complications increases in PATI scores greater than 25

Organ injured Risk Factor Scoring injury

1. Single wall
2. ≤ 25% wall
Duodenum 5 3. > 25% wall
4. Duodenum wall and blood supply
5. Pancreaticoduodenectomy
1. Tangential
2. Through and through (duct intact)
Pancreas 5 3. Major debridement or distal duct injury
4. Proximal duct injury
5. pancreaticoduodenectomy
1. Nonbleeding peripheral
2. Bleeding central or minor debridement
3. Major debridement and hepatic artery lidation
Liver 4
4. Lobectomy
5. Lobectomy with caval repair or extensive bilobar
debridement
1. Serosal
2. Single wall
Large in tasting 4 3. ≤ 25% wall
4. > 25% wall
5. Colon wall and blood supply
1. ≤ 25% wall
2. > 25% wall
Major vascular 4 3. Complete transaction
4. Interposition grafting or bypass
5. ligation
1. nonbleeding
2. cautery or hemostatic agent
spleen 3 3. minor debridement or suturing
4. partial resection
5. splenectomy
 1. nonbleeding
2. cautery or hemostatic agent
kidney 3 3. minor debridement or suturing
4. pedicle or major calyceal
5. nephrectomy
1. contusion
2. cholecystectomy
Extra hepatic
2 3. ≤ 25% common duct wall
biliary
4. > 25% common duct wall
5. Biliary enteric reconstruction
1. Single wall
2. Through and Through
Small bowel 2 3. ≤ 25% wall or 2-3 injuries
4. > 25% wall or 4-5 injuries
5. Wall and blood supply or > 5 injuries
1. Single wall
2. Through and through
stomach 2 3. Minor debridement
4. Wedge resection
5. > 35% resection
1. Contusion
2. Laceration
Ureter 2 3. Minor debridement
4. Segmental resection
5. reconstruction
1. single wall
2. through and through
bladder 1 3. debridement
4. wedge resection
5. reconstruction
1. periosteum
2. cortex
bone 1 3. through and through
4. intra – articulr
5. major bone loss
1. nonbleeding small hematoma
2. nonbleding large hematoma
Minor vascular 1 3. suturing
4. ligation of isolated vessels
5. ligartion of named vessels
Reference:
Moore EE, dunn EL, moore JB, Thompson JS. Penetrating abdominal trauma index. J trauma.
1981;21:439-445.