Outcomes of rural trauma patients who undergo damage control laparotomy

The majority of motor vehicle crashes occur in a rural setting and those patients have double the mortality of their urban counterparts. These trauma patients are at times stabilized at rural hospitals before transfer to a Level 1 trauma center. The purpose of this study was to determine the outcomes of rural damage control laparotomy used as a means of pre-transfer stabilization.

A nearly 7-year retrospective review was conducted of rural trauma patients who had laparotomies before or after transfer to Level 1 center. They were grouped into three categories: damage control laparotomy at rural hospital, patients unstable during transfer or stable during transfer with subsequent laparotomy.

Forty-seven patients met study criteria. Overall mortality was significantly different between patients who had damage control laparotomy at a rural hospital (14.3%), were unstable transfer patients (75.0%), and stable transfer patients (3.3%; P < 0.001).

Rural damage control laparotomy may be used as a means of stabilization prior to transfer to a Level 1 center, and in appropriate patients may be life-saving.