Journal article
Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes
The journal of trauma, v 52(3), pp 420-425
01 Mar 2002
PMID: 11901314
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVEWe examined the relationship between survival and time in the emergency department (ED) before laparotomy for hypotensive patients bleeding from abdominal injuries.METHODSPatients in the Pennsylvania Trauma Systems Foundation trauma registry with isolated abdominal vascular, solid organ, or wall injuries grade 3 to 6 and hypotension were identified. Deaths were predicted from the prehospital time, systolic blood pressure (SBP) on ED admission, and time in the ED before either laparotomy or ED death.RESULTSTwo-hundred forty-three patients met the criteria. SBP ranged from 30 to 90 mm Hg. Time to the ED ranged from 7 to 185 minutes. Time in the ED ranged from 7 to 915 minutes. Overall, 98 patients died (40%). The risk ratio for the SBP increased, as expected, as SBP dropped. The risk ratio for time spent in the ED before laparotomy increased until 90 minutes, then significantly decreased below all earlier values. Logistic regression on the 165 patients spending 90 minutes or less in the ED showed that the probability of death increased with time in the ED. The increase was as much as 0.35% per minute.CONCLUSIONAmong patients in a trauma registry who were hypotensive on arrival in the ED and had major injuries isolated to the abdomen requiring emergency laparotomy, the probability of death showed a relationship to both the extent of hypotension and the length of time in the ED for patients who were in the ED for 90 minutes or less. The probability of death increased approximately 1% for each 3 minutes in the ED.
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Details
- Title
- Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes
- Creators
- John R Clarke - University of PennsylvaniaStanley Z TrooskinPrashant J DoshiLloyd GreenwaldCharles J Mode
- Publication Details
- The journal of trauma, v 52(3), pp 420-425
- Publisher
- Lippincott
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- [Retired Faculty]
- Web of Science ID
- WOS:000174437100003
- Scopus ID
- 2-s2.0-0036120813
- Other Identifier
- 991019168371504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine
- Surgery