Trauma laparotomy in a rural setting before transfer to a regional center: does it save lives?
| Autor: | Weinberg JA; Mayo Clinic-Scottsdale, Arizona, USA., McKinley K, Petersen SR, Demarest GB, Timberlake GA, Gardner RS |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of trauma [J Trauma] 2003 May; Vol. 54 (5), pp. 823-6; discussion 826-8. |
| DOI: | 10.1097/01.TA.0000063001.61469.3E |
| Abstrakt: | Background: In the rural setting, long distances may necessitate that a patient undergo emergency laparotomy before transfer to a regional trauma center for definitive management. The purpose of this study was to review the experience of three regional trauma centers with such treated patients. Methods: This study was a retrospective chart review of patients who underwent emergency laparotomy for trauma before transfer, identified from the respective databases of participating centers over a 6-year period. Results: Fifty-six patients met the study criteria. Twenty-six (46%) were transferred primarily for management of the abdominal injury, and 14 of these patients (25% overall) underwent damage control procedures. Overall survival was 82%. Logistic regression demonstrated that transfer for treatment of the extra-abdominal injury was the only significant predictor of survival (odds ratio, 34.33; 95% confidence interval, 1.80-655.24). Conclusion: Although patients undergoing laparotomy who were subsequently transferred for management of abdominal injury have reasonable outcome, patients transferred primarily for management of extra-abdominal injury seem to have a survival advantage. |
| Databáze: | MEDLINE |
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