Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea

• Published in: Daehan oe'sang haghoeji 2024-03, Vol.37 (1), p.20-27
• Main Authors: Lee, Yu Jin, Jeong, Soon Tak, Kim, Joongsuck, Yeo, Kwanghee, Kwon, Ohsang, Kim, Kyounghwan, Park, Sung Jin, Gwak, Jihun, Kang, Wu Seong
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2799-4317; 2287-1683; 2287-1683
• DOI: 10.20408/jti.2023.0072

Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality and time taken from admission to ED laparotomy. We reviewed the data recorded in our center's trauma database between January 2020 and December 2022 and identified patients who underwent laparotomy because of abdominal trauma. Laparotomies that were performed at the trauma bay or the ED were classified as ED laparotomy, whereas those performed in the operating room (OR) were referred to as OR laparotomy. In cases that required expeditious hemostasis, ED laparotomy was performed appropriately. From January 2020 to December 2022, 105 trauma patients admitted to our hospital underwent emergency laparotomy. Of these patients, six (5.7%) underwent ED laparotomy. ED laparotomy was associated with a mortality rate of 66.7% (four of six patients), which was significantly higher than that of OR laparotomy (17.1%, 18 of 99 patients, P=0.006). All the patients who received ED laparotomy also underwent damage control laparotomy. The time between admission to the first laparotomy was significantly shorter in the ED laparotomy group (28.5 minutes; interquartile range [IQR], 14-59 minutes) when compared with the OR laparotomy group (104 minutes; IQR, 88-151 minutes; P