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Journals / Turkish Journal of Surgery / 2019 / Cilt: 35 - Sayı: 1

Analysis of trauma patients with unplanned returns to the operating room

Travma hastalarında plansız ameliyathaneye dönüş analizi

Taimoore Dogar
Jeffry Nahmias
Areg Grigorian
Sebastian Schubl
Viktor Gabriel
Austin Dosch
Victor Joe
Nicole Bernal
Pages
54–61
Publication Date
2022-11-05
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Both a blunt (compared to penetrating) mechanism and RT (compared to RL) are independent risk factors for mortality in patients undergoing an uROR.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Trauma patients undergoing damage-control surgery may have a planned return to the operating room.
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Key Findings & Data:Additionally, it is hypothesized that trauma patients with uROR after thoracotomy have higher mortality than patients with uROR after laparotomy.Material and Methods: A retrospective analysis of the National Trauma Data Bank from 2011-2015 including any adult patient with an uROR wasperformed.Results: From 3.447.320 patients, 9.269 (0.2%) were identified to have uROR.
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Conclusion & Impact:Both a blunt (compared to penetrating) mechanism and RT (compared to RL) are independent risk factors for mortality in patients undergoing an uROR.
🔬Design:Research Article
📍Scope:2011-2015 Verileri
⚙️Variables:Domain Parameters

Abstract

Objective: Trauma patients undergoing damage-control surgery may have a planned return to the operating room. In contrast, little is known aboutunplanned returns to the operating room (uROR) in trauma. The aim of this study was to identify risk factors for uROR in trauma patients. It is hypothesized that blunt trauma patients with uROR have higher mortality when compared to penetrating trauma patients with uROR. Additionally, it is hypothesized that trauma patients with uROR after thoracotomy have higher mortality than patients with uROR after laparotomy.Material and Methods: A retrospective analysis of the National Trauma Data Bank from 2011-2015 including any adult patient with an uROR wasperformed.Results: From 3.447.320 patients, 9.269 (0.2%) were identified to have uROR. In a multivariable logistic regression analysis, 27 independent predictorswere identified for risk of uROR with the strongest independent risk factor being compartment syndrome (OR= 10.50, CI= 9.35-11.78, p< 0.001). Blunt(compared to penetrating) mechanism was associated with higher risk for mortality in patents with uROR (OR= 1.69, CI= 1.14-2.51, p< 0.001) as was reincision thoracotomy (RT) compared to re-incision laparotomy (RL) (OR= 2.22, CI= 1.29-3.84, p< 0.001).Conclusion: The strongest risk factor for uROR in trauma is compartment syndrome. Both a blunt (compared to penetrating) mechanism and RT (compared to RL) are independent risk factors for mortality in patients undergoing an uROR.

Özet

Giriş ve Amaç: Hasar kontrol cerrahisi geçiren travma hastalarında ameliyathaneye planlı bir dönüş olabilir. Bunun aksine, travmada plansız ameliyathaneye dönüşler (PAD) hakkında çok az şey bilinmektedir. Bu çalışmanın amacı, travma hastalarında PAD risk faktörlerini belirlemekti. Ayrıca, plansız ameliyathaneye dönüşlü künt travma hastalarının plansız ameliyathaneye dönüşlü penetran travma hastalarına kıyasla daha yüksek mortalite oranına sahip olduğu varsayımında bulunduk. Buna ek olarak, torakotomi yapılan PAD travma hastalarının laparotomi yapılan hastalara oranla daha yüksek mortaliteye sahip olduğu da öne sürülmüştür. Gereç ve Yöntem: 2011-2015 yılları arasını kapsayacak şekilde Ulusal Travma Veri Bankasının plansız ameliyathaneye dönüşlü erişkin hastaların verileri üzerine geriye dönük analiz yapıldı. Bulgular: 3.447.320 hasta içerisinde 9269 (%0.2)’unun plansız ameliyathaneye dönüşlü hastalar olduğu belirlendi. Çok değişkenli lojistik regresyon analizinde, kompartıman sendromunun (OR= 10.50, CI= 9.35-11.78, p< 0.001) en güçlü bağımsız risk faktörü olduğu 27 bağımsız risk faktörü saptandı. Reinsizyon laparotomiye kıyasla reinsizyon torakotomide de olduğu gibi (OR= 2.22, CI= 1.29-3.84, p< 0.001) (penetran mekanizmaya kıyasla) künt mekanizma, plansız ameliyathaneye dönüşlü hastalarda daha yüksek mortalite riski ile ilişkiliydi. Sonuç: Travmada PAD için en güçlü risk faktörü kompartıman sendromudur. Plansız ameliyathaneye dönüşlü hastalarda hem penetran mekanizmaya kıyasla künt mekanizma hem de reinsizyon laparotomiye kıyasla reinsizyon torakotomi bağımsız risk faktörlerini oluşturmaktadır.

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Cite This Article

Dogar, T., Nahmias, J., Grigorian, A., Schubl, S., Gabriel, V., Dosch, A., Joe, V., Bernal, N. (2022). Analysis of trauma patients with unplanned returns to the operating room. Turkish Journal of Surgery, Cilt: 35 - Sayı: 1, 54–61. https://ajindex.com/articles/614357

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