Long-term impact of damage control lapaortomy: A prospective study

Megan Brenner, Grant Bochicchio, Kelly Bochicchio, Obeid Ilahi, Eduardo Rodriguez, Shaorn Henry, Manjari Joshi, Thomas Scalea

Research output: Contribution to journalArticle

Abstract

Hypothesis: Damage control lapaortomy (DCL) has beneficial effects on the long-term morbidity and survival of trauma patients. Design: Prospective study. Setting: Level I trauma center. Patients: Eighty-eight trauma patients who were admitted during a 3-year period (January 1, 2000, through December 31, 2003) underwent damage control lapaortomy and were subsequently followed up (January 1, 2001, through December 31, 2008). Intervention: Damage control lapaortomy. Main Outcome Measures: Major and long-term complications, lengths of stay, mortality, readmissions, subsequent surgical procedures, activities of daily living, and return to work. Results: On admission, the mean age and Injury Severity Score were 33 years and 34, respectively. Of the 88 patients, 66 (75%) were male; 46 patients had blunt injuries and 42 had penetrating injuries. Liver was the most common injury (63 patients), followed by bowel (34), spleen (33), major vessel (19), and pancreas (10). The mean admission pH and temperature were 7.19 and 34.4°C, respectively, with 21.5Uof packed red blood cells transfused. The mean (SD) number of initial abdominal operations was 4.6 (2.5) per patient, with an overall mortality of 28% (25 patients). Intensive care unit and hospital lengths of stay were 18 (15) and 32 (20) days, respectively. Of the 63 patients who survived, 58 underwent intra-abdominal closure with polyglactin mesh. During the study, 44 intra-abdominal infections and 18 enterocutaneous fistulas were diagnosed. All 63 survivors were readmitted at least once. There were a total of 186 readmissions and 92 subsequent surgical procedures. Ventral hernia repair (66 readmissions) was the most common reason for readmission, followed by infection (41) and fistula management (29). There was 0% mortality for patients who survived the preliminary hospitalization. Of the 63 surviving patients, 51 (81%) reported that they had gone back to work and resumed normal daily activities. Conclusion: Although damage control lapaortomy is associated with a significant complication and readmission rate, its overall benefit is indisputable.

Original languageEnglish (US)
Pages (from-to)395-399
Number of pages5
JournalArchives of Surgery
Volume146
Issue number4
DOIs
StatePublished - Apr 2011
Externally publishedYes

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Prospective Studies
Length of Stay
Return to Work
Wounds and Injuries
Mortality
Ventral Hernia
Intraabdominal Infections
Intestinal Fistula
Polyglactin 910
Nonpenetrating Wounds
Injury Severity Score
Trauma Centers
Herniorrhaphy
Activities of Daily Living
Fistula
Intensive Care Units
Survivors
Pancreas
Hospitalization
Spleen

ASJC Scopus subject areas

  • Surgery

Cite this

Brenner, M., Bochicchio, G., Bochicchio, K., Ilahi, O., Rodriguez, E., Henry, S., ... Scalea, T. (2011). Long-term impact of damage control lapaortomy: A prospective study. Archives of Surgery, 146(4), 395-399. https://doi.org/10.1001/archsurg.2010.284

Long-term impact of damage control lapaortomy : A prospective study. / Brenner, Megan; Bochicchio, Grant; Bochicchio, Kelly; Ilahi, Obeid; Rodriguez, Eduardo; Henry, Shaorn; Joshi, Manjari; Scalea, Thomas.

In: Archives of Surgery, Vol. 146, No. 4, 04.2011, p. 395-399.

Research output: Contribution to journalArticle

Brenner, M, Bochicchio, G, Bochicchio, K, Ilahi, O, Rodriguez, E, Henry, S, Joshi, M & Scalea, T 2011, 'Long-term impact of damage control lapaortomy: A prospective study', Archives of Surgery, vol. 146, no. 4, pp. 395-399. https://doi.org/10.1001/archsurg.2010.284
Brenner M, Bochicchio G, Bochicchio K, Ilahi O, Rodriguez E, Henry S et al. Long-term impact of damage control lapaortomy: A prospective study. Archives of Surgery. 2011 Apr;146(4):395-399. https://doi.org/10.1001/archsurg.2010.284
Brenner, Megan ; Bochicchio, Grant ; Bochicchio, Kelly ; Ilahi, Obeid ; Rodriguez, Eduardo ; Henry, Shaorn ; Joshi, Manjari ; Scalea, Thomas. / Long-term impact of damage control lapaortomy : A prospective study. In: Archives of Surgery. 2011 ; Vol. 146, No. 4. pp. 395-399.
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