AI Article Synopsis
- The study compares outcomes of hemodynamically stable trauma patients who underwent diagnostic laparoscopy (DL) versus nontherapeutic laparotomy (NL) over four years (2017-2020).
- Data from 3801 patients were analyzed, revealing that those who had DL experienced significantly lower odds of mortality and major complications, alongside shorter hospital stays.
- The findings suggest that DL is a more effective and safer option for stable trauma patients, reducing the need for unnecessary exploratory surgeries.
Article Abstract
Background: Diagnostic laparoscopy (DL) has been advocated to reduce the incidence of nontherapeutic laparotomies (NL) among stable trauma patients. This study aimed to compare the outcomes of hemodynamically stable trauma patients undergoing DL versus NL.
Methods: This is a retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program database over 4 y (2017-2020). Hemodynamically stable (systolic blood pressure >90 & heart rate < 120) adult (≥18 y) trauma patients undergoing DL or NL were included. Patients were stratified into DL and NL and substratified based on the mechanism of injury (blunt versus penetrating) and compared.
Results: Over 4 y, 3801 patients were identified, of which, 997 (26.2%) underwent DL. Overall, 25.6% sustained blunt injuries. The mean (SD) age was 39 (16) and 79.5% were male. The median injury severity score and abdominal abbreviated injury scale were 4 [4-9] and 1 [1-2], with no difference among study groups (P ≥ 0.05). The overall mortality and major complication rates were 2.8% and 13.2%, respectively. After controlling for potential confounding factors, DL was independently associated with lower odds of mortality (adjusted odds ratio: 0.10, 95% CI [0.04-0.29], P < 0.001) and major complications (adjusted odds ratio: 0.38, 95% CI [0.29-0.50], P < 0.001) and shorter hospital length of stay (β: -1.22, 95% CI [-1.78 to -0.67], P < 0.001). The trends toward improved outcomes in the DL group remained the same in the subanalysis of patients with penetrating and blunt injuries.
Conclusions: With advances in minimally invasive surgery, unnecessary exploratory laparotomy can be avoided in many trauma patients. Our study shows that hemodynamically stable patients undergoing DL had superior outcomes compared to those with NL.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jss.2024.08.014 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Service Quality in Iranian Hospitals From Patients' Perspectives Based on the SERVQUAL Model: A Systematic Review and Meta-Analysis.
Health Sci Rep
January 2025
Department of Medical-Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran.
Background: This study aimed to evaluate the service quality in Iranian hospitals from patients' perspectives based on the SERVQUAL model.
Materials And Methods: A thorough exploration of online electronic databases, including Scopus, PubMed, Web of Science, IranMedex, and the Scientific Information Database (SID), was undertaken using keywords extracted from Medical Subject Headings such as "Quality of Health Care," "Hospital," and "Patients" spanning from the earliest available records up to August 11, 2023.
Results: In the context of 25 cross-sectional studies encompassing a collective participant pool of 8021 hospitalized patients in Iranian medical facilities, an assessment of patients' perspectives on the quality of hospital services revealed a mean perception score of 3.
Hope for the best, but prepare for the worst - Diagnostic accuracy of the American College of Surgeons National Surgical Quality Improvement Program - Risk model for patients undergoing abdominoplasty after massive weight loss - Results from a Retrospective Cohort Study.
JPRAS Open
March 2025
Department of Orthopaedic, Trauma and Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany.
Background: This study aimed to validate the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) risk calculator for predicting outcomes in patients undergoing abdominoplasty after massive weight loss.
Methods: Patients' characteristics, pre-existing comorbidities and adverse outcomes in our department from 2013 to 2023 were collected retrospectively. Adverse events were defined according to ACS-NSQIP standards and predicted risks were calculated manually using the ACS-NSQIP risk calculator.
Randomized clinical trial of peer integrated collaborative care intervention after physical injury.
Trauma Surg Acute Care Open
January 2025
Department of Surgery, University of Washington School of Medicine, Seattle, Washington, USA.
Objectives: The goal of the current study was to assess the effectiveness of a peer integrated collaborative care intervention for postinjury outcomes.
Methods: Injury survivors ≥18 years of age were screened for post-traumatic stress disorder (PTSD) symptoms and severe postinjury concerns; screen-positive patients were randomized to the intervention versus enhanced usual care control conditions. The collaborative care intervention included peer support and care management.
Stressors contributing to burnout among acute care and trauma surgery care teams: a systems-analysis approach.
Trauma Surg Acute Care Open
January 2025
Division of Healthcare Engineering, Department of Radiation Oncology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Background: Burnout negatively impacts healthcare professionals' well-being, leading to an increased risk of human errors and patient harm. There are limited assessments of burnout and associated stressors among acute care and trauma surgery teams.
Methods: Acute care and trauma surgery team members at a US academic medical center were administered a survey that included a 2-item Maslach Burnout Inventory and 21 workplace stressors based on the National Academy of Medicine's systems model of clinician burnout and professional well-being.
SAFE-GOALS: a protocol for goals of care discussions in the intensive care unit.
Trauma Surg Acute Care Open
January 2025
Department of Surgery, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, Las Vegas, Nevada, USA.
Introduction: In critical care, there is often a lack of understanding regarding patient preferences toward end-of-life care. Goals of care discussions are poorly defined and inhibited by clinician apprehension, prognostic uncertainty, and discomfort from both sides. In the delivery of bad news, protocol-based discussions have proven beneficial, yet no such protocol exists for goals of care discussions in the intensive care unit (ICU).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!