Outcomes following trauma laparotomy for hypotensive trauma patients: A UK military and civilian perspective

The Journal of Trauma and Acute Care Surgery
Max MarsdenDouglas M Bowley

Abstract

The management of trauma patients has changed radically in the last decade, and studies have shown overall improvements in survival. However, reduction in mortality for the many may obscure a lack of progress in some high-risk patients. We sought to examine the outcomes for hypotensive patients requiring laparotomy in UK military and civilian cohorts. We undertook a review of two prospectively maintained trauma databases: the UK Joint Theatre Trauma Registry for the military cohort (February 4, 2003, to September 21, 2014) and the trauma registry of the Royal London Hospital major trauma center (January 1, 2012, to January 1, 2017) for civilian patients. Adults undergoing trauma laparotomy within 90 minutes of arrival at the emergency department (ED) were included. Hypotension was present on arrival at the ED in 155 (20.4%) of 761 military patients. Mortality was higher in hypotensive casualties (25.8% vs. 9.7% in normotensive casualties; p < 0.001). Hypotension was present on arrival at the ED in 63 (35.7%) of 176 civilian patients. Mortality was higher in hypotensive patients (47.6% vs. 12.4% in normotensive patients; p < 0.001). In both cohorts of hypotensive patients, neither the average injury severity, the prehospital tim...Continue Reading

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Citations

Feb 12, 2019·Intensive Care Medicine·Karim BrohiJohn B Holcomb
Feb 8, 2020·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Michael Hughes, Zane Perkins
May 7, 2019·British Journal of Hospital Medicine·Paul VulliamyRoss A Davenport
Dec 1, 2020·Military Medicine·David N NaumannDouglas M Bowley
Dec 12, 2020·Journal of Emergencies, Trauma, and Shock·Shahram PaydarShahin Mohseni
Jan 18, 2021·World Journal of Surgery·Dominik A JakobKenji Inaba
May 21, 2021·Journal of the American College of Surgeons·Max E R MarsdenUNKNOWN National Trauma Research and Innovation Collaborative (NaTRIC)
Feb 20, 2021·The Journal of Trauma and Acute Care Surgery·Joseph D BozzayUNKNOWN Infectious Disease Clinical Research Program Trauma Infectious Disease Outcomes Study Group
Oct 6, 2021·BMJ Military Health·Max E R MarsdenP Rees

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