Damage control or definitive repair? A retrospective review of abdominal trauma at a major trauma center in South Africa
| Autor: | Victor Kong, W Bekker, John L. Bruce, J J P Buitendag, Damian L. Clarke, Joanna M Blodgett, Grant L. Laing, Ross Weale, V Manchev, Abraham Ras |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
business.industry Major trauma hemic and immune systems Traumatology Critical Care and Intensive Care Medicine medicine.disease Surgery critical care trauma laparotomy Abdominal trauma 4th World Trauma Congress Article Damage control surgery medicine Injury Severity Score damage control business Trauma surgery Penetrating trauma Abdominal surgery |
| Zdroj: | Trauma Surgery & Acute Care Open |
| ISSN: | 2397-5776 |
| DOI: | 10.1136/tsaco-2018-000235 |
| Popis: | BackgroundThis study set out to review a large series of trauma laparotomies from a single center and to compare those requiring damage control surgery (DCS) with those who did not, and then to interrogate a number of anatomic and physiologic scoring systems to see which best predicted the need for DCS.MethodsAll patients over the age of 15 years undergoing a laparotomy for trauma during the period from December 2012 to December 2017 were retrieved from the Hybrid Electronic Medical Registry (HEMR) at the Pietermaritzburg Metropolitan Trauma Service (PMTS), South Africa. They were divided into two cohorts, namely the DCS and non-DCS cohort, based on what was recorded in the operative note. These groups were then compared in terms of demographics and spectrum of injury, as well as clinical outcome. The following scores were worked out for each patient: Penetrating Abdominal Trauma Index (PATI), Injury Severity Score, Abbreviated Injury Scale-abdomen, and Abbreviated Injury Scale-chest.ResultsA total of 562 patients were included, and 99 of these (18%) had a DCS procedure versus 463 (82%) non-DCS. The mechanism was penetrating trauma in 81% of cases (453 of 562). A large proportion of trauma victims were male (503 of 562, 90%), with a mean age of 29.5±10.8. An overall mortality rate of 32% was recorded for DCS versus 4% for non-DCS (pConclusionDCS is indicated in a subset of severely injured trauma patients. A pH Levels of evidenceLevel III. |
| Databáze: | OpenAIRE |
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