Paige A Harwell1, Jared Reyes1, Stephen D Helmer2, James M Haan3. 1. Department of Surgery, The University of Kansas School of Medicine - Wichita, Wichita, KS, USA. 2. Department of Surgery, The University of Kansas School of Medicine - Wichita, Wichita, KS, USA; Department of Medical Education, Via Christi Hospital Saint Francis, Wichita, KS, USA. 3. Department of Surgery, The University of Kansas School of Medicine - Wichita, Wichita, KS, USA; Department of Trauma Services, Via Christi Hospital Saint Francis, Wichita, KS, USA. Electronic address: James.Haan.Research@ascension.org.
Abstract
BACKGROUND: The majority of motor vehicle crashes occur in a rural setting and those patients have double the mortality of their urban counterparts. These trauma patients are at times stabilized at rural hospitals before transfer to a Level 1 trauma center. The purpose of this study was to determine the outcomes of rural damage control laparotomy used as a means of pre-transfer stabilization. METHODS: A nearly 7-year retrospective review was conducted of rural trauma patients who had laparotomies before or after transfer to Level 1 center. They were grouped into three categories: damage control laparotomy at rural hospital, patients unstable during transfer or stable during transfer with subsequent laparotomy. RESULTS: Forty-seven patients met study criteria. Overall mortality was significantly different between patients who had damage control laparotomy at a rural hospital (14.3%), were unstable transfer patients (75.0%), and stable transfer patients (3.3%; P < 0.001). CONCLUSION: Rural damage control laparotomy may be used as a means of stabilization prior to transfer to a Level 1 center, and in appropriate patients may be life-saving.
BACKGROUND: The majority of motor vehicle crashes occur in a rural setting and those patients have double the mortality of their urban counterparts. These traumapatients are at times stabilized at rural hospitals before transfer to a Level 1 trauma center. The purpose of this study was to determine the outcomes of rural damage control laparotomy used as a means of pre-transfer stabilization. METHODS: A nearly 7-year retrospective review was conducted of rural traumapatients who had laparotomies before or after transfer to Level 1 center. They were grouped into three categories: damage control laparotomy at rural hospital, patients unstable during transfer or stable during transfer with subsequent laparotomy. RESULTS: Forty-seven patients met study criteria. Overall mortality was significantly different between patients who had damage control laparotomy at a rural hospital (14.3%), were unstable transfer patients (75.0%), and stable transfer patients (3.3%; P < 0.001). CONCLUSION:Rural damage control laparotomy may be used as a means of stabilization prior to transfer to a Level 1 center, and in appropriate patients may be life-saving.
Authors: Constance McGraw; Charles W Mains; Jodie Taylor; Cecile D'Huyvetter; Kristin Salottolo; David Bar-Or Journal: Patient Saf Surg Date: 2022-09-09