When is it safe to discharge asymptomatic patients with abdominal stab wounds?

Background: This study sought to determine the time from hospital presentation to surgical intervention for hemodynamically stable patients with abdominal stab wounds. The objective was to identify the optimal time for observation of these asymptomatic patients before safe hospital discharge.

Methods: The authors reviewed a prospectively collected trauma database at their level 1 trauma center. The time from admission to surgery was noted in their patient population. All stab wound patients who underwent either peritoneal lavage or immediate surgery were excluded from the study.

Results: During a 7-year period, 650 asymptomatic patients with abdominal stab wounds were admitted for serial examination. The study showed that 567 of these patients had no abdominal surgical intervention, whereas 68 underwent abdominal surgery (15 left the center against medical advice). No patients were identified as requiring surgery more than 12 hours after presentation.

Conclusion: It appears that asymptomatic patients with abdominal stab wounds may be discharged from the hospital after 12 hours of observation with little likelihood of missed injury.