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Published in: Langenbeck's Archives of Surgery 1/2015

01-01-2015 | Original Article

Complications after laparotomy for trauma: a retrospective analysis in a level I trauma centre

Authors: Matthijs H. van Gool, Georgios F. Giannakopoulos, Leo M. G. Geeraedts Jr., Elly S. M. de Lange-de Klerk, Wietse P. Zuidema

Published in: Langenbeck's Archives of Surgery | Issue 1/2015

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Abstract

Purpose

Laparotomy is a potential life-saving procedure after traumatic abdominal injury. There is limited literature about morbidity and mortality rates after trauma laparotomy. The primary aim of this study is to describe the complications which may occur due to laparotomy for trauma.

Methods

Retrospective evaluated single-centre study with data registry up to 1 year after initial laparotomy for trauma was performed in a level 1 trauma centre in The Netherlands. Between January 2000 and January 2011, a total of 2390 severely injured trauma patients (ISS ≥ 16) were transported to the VUMC. Patient demographics; mechanism of injury; injury patterns defined by Abbreviated Injury Scale (AIS), Injury Severity Score (ISS) and Revised Trauma Score (RTS); surgical interventions and findings; and morbidity and mortality were documented.

Results

A total of 92 trauma patients who underwent a trauma laparotomy met the inclusion criteria. Of these patients, 71 % were male. Median age was 37 years. Median ISS was 27. Mechanisms of injury comprised of car accidents (20 %), fall from height (17 %), motorcycle accidents (12 %), pedestrian/cyclist hit by a vehicle (9 %) and other in three patients (5 %). Penetrating injuries accounted for 37 % of the injuries, consisting of stab wounds (21 %) and gunshot wounds (16 %). Complications classified by the Clavien-Dindo Classification of Surgical Complications showed grade I complications in 21 patients (23 %), grade II in 36 patients (39 %), grade III in 21 patients (23 %), grade IV in 2 patients (2 %) and grade V in 16 patients (17 %).

Conclusion

Laparotomy for trauma has a high complication rate resulting in significant morbidity and mortality. Most events occur in the early postoperative period. Further prospective research needs to be conducted in order to identify possibilities to improve care in the future.
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Metadata
Title
Complications after laparotomy for trauma: a retrospective analysis in a level I trauma centre
Authors
Matthijs H. van Gool
Georgios F. Giannakopoulos
Leo M. G. Geeraedts Jr.
Elly S. M. de Lange-de Klerk
Wietse P. Zuidema
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 1/2015
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-014-1260-0

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