PMID: 11901314Mar 20, 2002Paper

Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes

The Journal of Trauma
John R ClarkeCharles J Mode

Abstract

We examined the relationship between survival and time in the emergency department (ED) before laparotomy for hypotensive patients bleeding from abdominal injuries. Patients in the Pennsylvania Trauma Systems Foundation trauma registry with isolated abdominal vascular, solid organ, or wall injuries grade 3 to 6 and hypotension were identified. Deaths were predicted from the prehospital time, systolic blood pressure (SBP) on ED admission, and time in the ED before either laparotomy or ED death. Two-hundred forty-three patients met the criteria. SBP ranged from 30 to 90 mm Hg. Time to the ED ranged from 7 to 185 minutes. Time in the ED ranged from 7 to 915 minutes. Overall, 98 patients died (40%). The risk ratio for the SBP increased, as expected, as SBP dropped. The risk ratio for time spent in the ED before laparotomy increased until 90 minutes, then significantly decreased below all earlier values. Logistic regression on the 165 patients spending 90 minutes or less in the ED showed that the probability of death increased with time in the ED. The increase was as much as 0.35% per minute. Among patients in a trauma registry who were hypotensive on arrival in the ED and had major injuries isolated to the abdomen requiring emergen...Continue Reading

References

Feb 1, 1992·The British Journal of Surgery·B P McNicholl, C H Dearden
Jan 1, 1991·Journal of Clinical Epidemiology·D L SimelD B Matchar
Dec 1, 1989·The Journal of Trauma·A R GillottC Forrester
Oct 27, 1994·The New England Journal of Medicine·W H BickellK L Mattox
Apr 12, 2000·The British Journal of Surgery·K I HendersonK Brohi

❮ Previous
Next ❯

Citations

Nov 1, 2011·Medizinische Klinik, Intensivmedizin und Notfallmedizin·J K KlothW Hosch
Oct 10, 2008·Der Anaesthesist·T KirschningF Walcher
Aug 10, 2010·Der Anaesthesist·V MannM Bernhard
Sep 21, 2007·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·C ProbstC Krettek
Aug 5, 2004·Der Unfallchirurg·A BeckA Schmelz
Mar 9, 2011·Langenbeck's Archives of Surgery·Michael FrinkFrank Hildebrand
Aug 19, 2011·Langenbeck's Archives of Surgery·Matthias HeuerUNKNOWN Trauma Registry of the DGU
Mar 15, 2002·Journal of the American College of Surgeons·David B Hoyt
Dec 17, 2008·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Thomas Erik WurmbJörg Brederlau
Feb 4, 2010·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Henrik JørgensenJesper Dirks
Dec 10, 2009·The Journal of Trauma·John F BilelloBabak Egbalieh
Jun 12, 2010·The Journal of Trauma·Gina M HowellJason L Sperry
Aug 9, 2012·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Daiki WadaSatoshi Fujimi
Sep 24, 2013·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Sigrid GrovenChristine Gaarder
Sep 13, 2013·Critical Care : the Official Journal of the Critical Care Forum·Daiki WadaSatoshi Fujimi
Jan 22, 2008·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Markus KörnerUlrich Linsenmaier
Mar 14, 2014·Der Unfallchirurg·P LechlerM Frink
Jun 26, 2014·Der Anaesthesist·A GriesUNKNOWN BoLuS-Studiengruppe
May 15, 2012·Radiographics : a Review Publication of the Radiological Society of North America, Inc·David Dreizin, Felipe Munera
Dec 1, 2012·World Journal of Surgery·Bellal JosephPeter Rhee

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.