Abstract
Purpose
The purpose of our study is to identify risk factors associated with unplanned or early reoperations in trauma patients with truncal injuries who received damage control surgeries.
Methods
This was an Institutional Review Board approved, single center, retrospective cohort evaluation. Trauma patients with truncal injuries who required an index surgery for damage control followed by a reoperation were divided into two groups based on the timing of their reoperation, planned (reoperation within 24–48 h) and unplanned groups (reoperation < 24 h). The primary outcome was to identify risk factors associated with unplanned trips to the operating room following the index surgery.
Results
Of the 142 trauma patients who underwent a damage control surgery, 42 patients were included for analysis (24 in the planned group and 18 in the unplanned group). The most common causes for unplanned reoperations were hemodynamic instability (n = 7) and bleeding (n = 8). Vasopressor administration (OR = 10.5, 95% CI [2.475, 44.54]), shock index > 1.2 (OR = 5.9, 95% CI [1.35, 25.88], and hemoglobin (Hgb) < 10 and/or a hematocrit (Hct) < 29 (OR = 8, 95% CI [1.5, 46.65] and/or OR = 17, 95% CI [1.94, 148.85], respectively) were associated with an increased odds of an unplanned return to the operating room.
Conclusion
Following damage control surgery, vasopressor administration, elevated shock index, and decreased Hemoglobin/Hematocrit may help identify patients who are at risk of requiring early or unplanned returns to the operating room.
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