They only come out at night: Impact of time of day on outcomes after penetrating abdominal trauma
| Autor: | Louis J. Magnotti, Emily K. Lenart, Martin A. Croce, John P. Sharpe, Richard H. Lewis, Peter E. Fischer |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Surgery Open Science, Vol 2, Iss 4, Pp 1-4 (2020) Surgery Open Science |
| ISSN: | 2589-8450 |
| Popis: | Background Patients who present at night following penetrating abdominal trauma are thought to have more severe injuries and increased risk for morbidity and mortality. The current literature is at odds regarding this belief. The purpose of this study was to evaluate time of day on outcomes following laparotomy for penetrating abdominal trauma. Methods Patients undergoing laparotomy following penetrating abdominal trauma over a 12-month period at a level I trauma center were stratified by age, sex, severity of shock, injury, operative complexity, and time of day (DAY = 0700–1900, NIGHT = 1901–0659). Outcomes of damage control laparotomy, ventilator days, intensive care unit length of stay, hospital length of stay, morbidity, and mortality were compared between DAY and NIGHT. Results A total of 210 patients were identified: 145 (69%) comprised NIGHT, and 65 (31%) comprised DAY. Overall mortality was 2.9%. Both injury severity and intraoperative transfusions were increased with NIGHT with no difference in morbidity (37% vs 40%, P = 0.63) or mortality (2.1% vs 4.6%, P = 0.31). Adjusting for sex, time of day, injury severity, and operative complexity, only abdominal abbreviated injury severity (odds ratio 1.46; 95% confidence interval 1.07–1.99, P = .019) and operative transfusions (odds ratio 1.18; 95% confidence interval 1.09–1.28, P Highlights • The majority of operative penetrating abdominal trauma occurs at night. • These patients have increased injury burden, more operative transfusions, and increased use of DCL. • Patients who present to a level 1 trauma center with penetrating abdominal trauma should not have any difference in morbidity and mortality based on time of day at presentation. • There is a significant need to understand and evaluate variations in timing of trauma burdens to appropriately staff and provide adequate resources for optimal outcomes regardless of time at presentation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|