Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea
Purpose Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality a...
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| Format: | Article |
| Language: | English |
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Korean Society of Traumatology
2024-03-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://jtraumainj.org/upload/pdf/jti-2023-0072.pdf |
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| author | Yu Jin Lee Soon Tak Jeong Joongsuck Kim Kwanghee Yeo Ohsang Kwon Kyounghwan Kim Sung Jin Park Jihun Gwak Wu Seong Kang |
| author_facet | Yu Jin Lee Soon Tak Jeong Joongsuck Kim Kwanghee Yeo Ohsang Kwon Kyounghwan Kim Sung Jin Park Jihun Gwak Wu Seong Kang |
| author_sort | Yu Jin Lee |
| collection | DOAJ |
| description | Purpose Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality and time taken from admission to ED laparotomy. Methods We reviewed the data recorded in our center’s trauma database between January 2020 and December 2022 and identified patients who underwent laparotomy because of abdominal trauma. Laparotomies that were performed at the trauma bay or the ED were classified as ED laparotomy, whereas those performed in the operating room (OR) were referred to as OR laparotomy. In cases that required expeditious hemostasis, ED laparotomy was performed appropriately. Results From January 2020 to December 2022, 105 trauma patients admitted to our hospital underwent emergency laparotomy. Of these patients, six (5.7%) underwent ED laparotomy. ED laparotomy was associated with a mortality rate of 66.7% (four of six patients), which was significantly higher than that of OR laparotomy (17.1%, 18 of 99 patients, P=0.006). All the patients who received ED laparotomy also underwent damage control laparotomy. The time between admission to the first laparotomy was significantly shorter in the ED laparotomy group (28.5 minutes; interquartile range [IQR], 14–59 minutes) when compared with the OR laparotomy group (104 minutes; IQR, 88–151 minutes; P<0.001). The two patients who survived after ED laparotomy had massive mesenteric bleeding, which was successfully ligated. The other four patients, who had liver laceration, kidney rupture, spleen injury, and pancreas avulsion, succumbed to the injuries. Conclusions Although ED laparotomy was associated with a higher mortality rate, the time between admission and ED laparotomy was markedly shorter than for OR laparotomy. Notably, major mesenteric hemorrhages were effectively controlled through ED laparotomy. |
| format | Article |
| id | doaj-art-5f4f8558fb2a4c638fafb2b5838bec9d |
| institution | Kabale University |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-5f4f8558fb2a4c638fafb2b5838bec9d2025-01-16T06:10:09ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832024-03-01371202710.20408/jti.2023.00721290Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in KoreaYu Jin Lee0Soon Tak Jeong1Joongsuck Kim2Kwanghee Yeo3Ohsang Kwon4Kyounghwan Kim5Sung Jin Park6Jihun Gwak7Wu Seong Kang8 Department of Emergency Medicine, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Physical Medicine and Rehabilitation, Ansanhyo Hospital, Ansan, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, KoreaPurpose Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality and time taken from admission to ED laparotomy. Methods We reviewed the data recorded in our center’s trauma database between January 2020 and December 2022 and identified patients who underwent laparotomy because of abdominal trauma. Laparotomies that were performed at the trauma bay or the ED were classified as ED laparotomy, whereas those performed in the operating room (OR) were referred to as OR laparotomy. In cases that required expeditious hemostasis, ED laparotomy was performed appropriately. Results From January 2020 to December 2022, 105 trauma patients admitted to our hospital underwent emergency laparotomy. Of these patients, six (5.7%) underwent ED laparotomy. ED laparotomy was associated with a mortality rate of 66.7% (four of six patients), which was significantly higher than that of OR laparotomy (17.1%, 18 of 99 patients, P=0.006). All the patients who received ED laparotomy also underwent damage control laparotomy. The time between admission to the first laparotomy was significantly shorter in the ED laparotomy group (28.5 minutes; interquartile range [IQR], 14–59 minutes) when compared with the OR laparotomy group (104 minutes; IQR, 88–151 minutes; P<0.001). The two patients who survived after ED laparotomy had massive mesenteric bleeding, which was successfully ligated. The other four patients, who had liver laceration, kidney rupture, spleen injury, and pancreas avulsion, succumbed to the injuries. Conclusions Although ED laparotomy was associated with a higher mortality rate, the time between admission and ED laparotomy was markedly shorter than for OR laparotomy. Notably, major mesenteric hemorrhages were effectively controlled through ED laparotomy.http://jtraumainj.org/upload/pdf/jti-2023-0072.pdflaparotomywounds and injurieshospital emergency service |
| spellingShingle | Yu Jin Lee Soon Tak Jeong Joongsuck Kim Kwanghee Yeo Ohsang Kwon Kyounghwan Kim Sung Jin Park Jihun Gwak Wu Seong Kang Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea Journal of Trauma and Injury laparotomy wounds and injuries hospital emergency service |
| title | Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea |
| title_full | Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea |
| title_fullStr | Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea |
| title_full_unstemmed | Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea |
| title_short | Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea |
| title_sort | emergency department laparotomy for patients with severe abdominal trauma a retrospective study at a single regional trauma center in korea |
| topic | laparotomy wounds and injuries hospital emergency service |
| url | http://jtraumainj.org/upload/pdf/jti-2023-0072.pdf |
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