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Risk factors for late death of patients with abdominal trauma after damage control laparotomy for hemostasis
Li-Min Liao, Chih-Yuan Fu, Shang-Yu Wang1
1Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, 5 Fu-Hsing Street, Taoyuan, Kwei Shan Township, Taiwan. shangyuwang@gmail.com.
Introduction:
In this study, we explored the possible causes of death and risk factors in patients who overcame the initial critical circumstance when undergoing a damage control laparotomy for abdominal trauma and succumbed later to their clinical course.
Methods:
This was a retrospective study. We selected patients who fulfilled our study criteria from 2002 to 2012. The medical and surgical data of these patients were then reviewed. Fifty patients (survival vs. late death, 39 vs. 11) were enrolled for further analysis.
Results:
In a univariable analysis, most of the significant factors were noted in the initial emergency department (ED) stage and early intensive care unit (ICU) stage, while an analysis of perioperative factors revealed a minimal impact on survival. Initial hypoperfusion (pH, BE, and GCS level) and initial poor physiological conditions (body temperature, RTS, and CPCR at ED) may contribute to the patient's final outcome. An analysis and summary of the causes of death were also performed.
Conclusions:
According to our study, the risk factors for late death in patients undergoing DCL may include both the initial trauma-related status and clinical conditions after DCL. In our series, the cause of death for patients with late mortality included the initial brain insult and later infectious complications.
