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The length of hospital stay after an unnecessary laparotomy for trauma: a prospective study
1Grady Memorial Hospital, Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Objective:
To record length of hospital stay (LOS) for patients for whom unnecessary laparotomies for trauma (no repair, no drain) were performed. The influence of complications and associated injuries on the LOS would be studied.
Design:
Prospective case series.
Materials And Methods:
Data were recorded concurrently for consecutive patients on whom unnecessary laparotomies for trauma were performed at a trauma center.
Measurements And Main Results:
The main and secondary outcome measures were LOS and the influence of complications or associated injuries on the LOS, respectively. From 1988 until 1991, unnecessary laparotomies for trauma were performed on 254 patients. The overall mean LOS was 8.1 days (median, 6 days; range, 1-80 days), whereas the overall mean LOS for 81 patients who had no associated injuries and on whom completely negative laparotomies were performed was 4.7 days (median, 5 days; range, 2-8 days). Complications occurred in 41.3% of the patients and increased the mean LOS from 5 days (no complication) to 9 days (complication) (p = 0.0002). Associated injuries occurred in 43.7% of the patients and increased the mean LOS from 5.3 days (no associated injury) to 11.7 days (associated injury) (p = 0.0001).
Conclusions:
Unnecessary laparotomies for trauma resulted in a significant LOS. The presence of a complication or an associated injury significantly prolonged the LOS. Current efforts to reduce the incidence of these unnecessary procedures and minimize the occurrence of complications are worthwhile.