Decision-making criteria for damage control surgery in Japan

Area of Science:

• Trauma Surgery
• Surgical Critical Care
• Emergency Medicine

Background:

• Optimal criteria for damage control surgery (DCS) in abdominal trauma remain debated.
• Emergency laparotomy is a critical intervention for severe abdominal injuries.

Purpose of the Study:

• To propose an indication for implementing DCS in patients requiring emergency laparotomy for abdominal trauma.
• To develop and validate a predictive score for DCS necessity.

Main Methods:

• Multicenter, retrospective, observational study using the Japan Trauma Data Bank.
• Inclusion of patients undergoing emergency laparotomy for abdominal trauma.
• Logistic regression analysis to identify independent predictors of DCS.

Main Results:

• Body temperature, Glasgow Coma Scale score, and injury type (blunt/penetrating) were independent predictors of DCS.
• The developed Damage Control Indication Detecting score correlated positively with mortality.
• The score achieved 64.8% sensitivity and 70.0% specificity for DCS indication.

Conclusions:

• The Damage Control Indication Detecting score can assist surgeons in determining the need for DCS in abdominal trauma.
• The study's findings, based on a population with predominantly blunt injuries, may have limited international applicability.