Effects of moving emergency trauma laparotomies from the ED to a dedicated OR

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Christine Gaarder¹  Nils Oddvar Skaga³  Paal Aksel Naess¹  Sigrid Groven² 

[1] Department of Traumatology, Oslo University Hospital- Ulleval, Oslo, Norway;Department of Traumatology, Division of Emergency and Critical Care, Oslo University Hospital- Ulleval, PO Box 4956, Nydalen N-0424, Oslo, Norway;Department of Anaesthesiology, Oslo University Hospital- Ulleval, Oslo, Norway

关键词: Survival;    Emergency department;    Laparotomy;    Abdominal injury;    Trauma;   

Others  :  810697
DOI  :  10.1186/1757-7241-21-72

 received in 2013-05-10, accepted in 2013-09-15,  发布年份 2013

【 摘 要 】

Introduction

The trauma room at Oslo University Hospital- Ulleval is fully equipped for major damage control procedures, in order to minimize delay to surgery. Since 2006, patients in need of immediate laparotomy have increasingly been transferred to a dedicated trauma operating room (OR). We wanted to determine the decrease in number of procedures performed in the emergency department (ED), the effect on time from admission to laparotomy, the effect on non-therapeutic laparotomies, and finally to determine whether such a change could be undertaken without an increase in mortality.

Methods

Retrospective evaluation of haemodynamically unstable trauma patients undergoing laparotomy during the period 2002–2009. Based on time for protocol change Period 1 was defined as 2002–2006 and Period 2 as 2007–2009. Significance was set at p < 0.05.

Results

A total of 167 consecutive patients were included; 103 patients from Period 1 and 64 from Period 2. We found a 42% decrease in ED laparotomies (p < 0.001). Median time to laparotomy increased from 24.0 to 34.0 minutes from Period 1 to Period 2 (p = 0.029). Crude mortality fell from 57% to 39%. The proportion of non-therapeutic laparotomies in the OR tended to be lower over the whole study period.

Conclusion

Moving this cohort of haemodynamically compromised trauma patients in need of emergency laparotomy out of the ED to a dedicated OR resulted in longer median time to laparotomy, but did not increase mortality.

【 授权许可】

   
2013 Groven et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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